NPIMap

Organization Active NPI

Yellville-Summit Health Center

  • Family Nurse Practitioner
  • Yellville, AR
National Provider Identifier
1114359619
Registry record updated Sep 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
YELLVILLE-SUMMIT HEALTH CENTER
Practice address
1201 N. Panther Ave
Yellville, AR 72687
Phone
(870) 449-9742
NPI assigned
Aug 7, 2013
Organization subpart
Yes
Parent organization
BAXTER COUNTY REGIONAL HOSPITAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Debra Henry
Title
Cfo
Phone
(870) 508-1003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1201 N. Panther Ave
Yellville, AR 72687

Mailing address

PO Box 277
Yellville, AR 72687-0277
Phone (870) 449-9742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120326000509 AR Part B Supplier - Clinic/Group Practice 0042389264 Receives reassigned benefits from 9 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mountain Home, AR

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
BCRH ER Prof Fees

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506556800000",
    "number": "1114359619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277",
            "city": "YELLVILLE",
            "state": "AR",
            "postal_code": "726870277",
            "telephone_number": "870-449-9742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N. PANTHER AVE",
            "city": "YELLVILLE",
            "state": "AR",
            "postal_code": "72687",
            "telephone_number": "870-449-9742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YELLVILLE-SUMMIT HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAXTER COUNTY REGIONAL HOSPITAL, INC",
        "enumeration_date": "2013-08-07",
        "last_updated": "2017-09-28",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "870-508-1003",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yellville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.