NPIMap

Organization Active NPI

Baxter County Regional Hospital, Inc

Doing business as Baxter Health Premier Family Clinic

  • Family Medicine Physician
  • Harrison, AR
National Provider Identifier
1144908351
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BAXTER COUNTY REGIONAL HOSPITAL, INC
Doing business as
Baxter Health Premier Family Clinic
Practice address
1417 Gladden St
Harrison, AR 72601-2236
Phone
(870) 741-0016
NPI assigned
Jul 7, 2023
Last updated
Jul 7, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
BAXTER COUNTY REGIONAL HOSPITAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Authorized official

Name
Lucinda Crow
Title
System Data Analyst
Phone
(870) 508-1081

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1417 Gladden St
Harrison, AR 72601-2236

Mailing address

1417 Gladden St
Harrison, AR 72601-2236
Phone (870) 741-0016

Other names 1

  • Baxter Health Premier Family Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211124000016 AR Part B Supplier - Clinic/Group Practice 0042389264 Receives reassigned benefits from 11 practitioners
1 other NPI on this enrollment
Practice locations: Flippin, AR; Harrison, AR

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
Baxter Cty Reg Hosp16 organizations share this tax ID, including this one
Part of
Baxter Cty Reg Hosp

Other organizations with this tax ID 15

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

View all 15

Locations

1417 Gladden St
Harrison, AR 72601
Phone (870) 741-0016

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": "1688688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1144908351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 GLADDEN ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012236",
            "telephone_number": "870-741-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 GLADDEN ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012236",
            "telephone_number": "870-741-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAXTER COUNTY REGIONAL HOSPITAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAXTER COUNTY REGIONAL HOSPITAL, INC",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-07-07",
        "certification_date": "2023-06-30",
        "status": "A",
        "authorized_official_last_name": "CROW",
        "authorized_official_first_name": "LUCINDA",
        "authorized_official_title_or_position": "SYSTEM DATA ANALYST",
        "authorized_official_telephone_number": "870-508-1081"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baxter Health Premier Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrison, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.