NPIMap

Organization Active NPI

Arkansas Health Group

Doing business as Baptist Health Specialty Clinic Arkadelphia

  • Surgery Physician
  • Arkadelphia, AR
National Provider Identifier
1124636279
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ARKANSAS HEALTH GROUP
Doing business as
Baptist Health Specialty Clinic Arkadelphia
Practice address
2915 Cypress Rd Ste D
Arkadelphia, AR 71923-4243
Phone
(870) 246-5097
Fax
(870) 246-9693
NPI assigned
Jul 15, 2020
Last updated
Jul 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Authorized official

Name
Will Rusher
Title
Ceo
Phone
(501) 812-7800

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Obstetrics & Gynecology Physician 207V00000X NU
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

2915 Cypress Rd Ste D
Arkadelphia, AR 71923-4243

Mailing address

11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (501) 812-7215

Other names 1

  • Baptist Health Specialty Clinic Arkadelphia Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070607000040 AR Part B Supplier - Clinic/Group Practice 7911802079 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arkadelphia, AR

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Jeffrey S Mayfield49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

Organizations that report the same tax identification number in the National Provider Directory.

View all 48

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1124636279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "501-812-7215",
            "fax_number": "501-812-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 CYPRESS RD STE D",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719234243",
            "telephone_number": "870-246-5097",
            "fax_number": "870-246-9693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS HEALTH GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-15",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "RUSHER",
        "authorized_official_first_name": "WILL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "501-812-7800"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Health Specialty Clinic Arkadelphia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arkadelphia, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.