Baxter County Regional Hospital Inc
Organization Active NPI Anesthesiology Physician · Mountain Home, AR
NPI 1114178753 · NPPES record last updated Feb 6, 2023
Key facts
- NPI
- 1114178753
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- BAXTER COUNTY REGIONAL HOSPITAL INC
- Practice address
- 624 Hospital Dr
Mountain Home, AR 72653-2955 - Phone
- (870) 508-1000
- Fax
- (870) 425-6616
- NPI assigned
- Oct 1, 2008
- Organization subpart
- No
Authorized official
- Name
- Debra Henry
- Title
- Chief Financial Officer
- Phone
- (870) 508-1003
Other NPIs with the same Medicare PAC ID 11
Member of 1
Practitioners 163
-
Cindy E Hall, CRNA
-
Michelle Leppert, CRNA, MSA, RN
-
Leslie Gloe, CRNA
-
Christina L Smith, CRNA
-
Lacey R Vanemburg, CRNA
-
Mark D Adkins, CRNA
-
Jana Allen, CRNA
-
Brett Baugh, CRNA
-
Matthew Bolding, CRNA
-
Gale Brantley, CRNA
-
Terry Ray Brewer Jr., CRNA
-
Jon R Connelley, MD
-
Jonathan David Crafton, CRNA
-
Jordan Frey Eldridge, CRNA
-
Dennis Epperson Jr., CRNA
-
William R Garner, CRNA
-
Candace May Goodwin, CRNA
-
Dylan Keith Griffin, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081212000269 | AR | Part B Supplier - Clinic/Group Practice | 0042389264 |
Receives reassigned benefits from 87 practitioners Practice locations: Salem, AR; Harrison, AR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes |
Addresses
Primary practice location
624 Hospital Dr
Mountain Home, AR 72653-2955
Mailing address
624 Hospital Dr
Mountain Home, AR 72653-2955
Phone (870) 508-1000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 176102002 | Medicaid | AR | |
| 770091002 | Other | AR | BREASTCARE |
Other names
- BRMC Anesthesia
Other providers in Mountain Home, AR
- Baxter County Regional Hospital
- Baxter County Regional Hospital
- Baxter County Regional Hospital Inc
- Baxter County Regional Hospital Inc
- Baxter County Regional Hospital Inc
- Baxter County Regional Hospital Inc
- Baxter County Regional Hospital Inc
- Baxter County Regional Hospital Inc
- Baxter County Regional Hospital Inc
- Baxter County Regional Hospital Inc
All providers in Mountain Home, AR · Anesthesiology Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.