Healthstar Physicians of Hot Springs, PLLC
Organization Active NPI Family Medicine Physician · Hot Springs, AR
NPI 1154076479 · NPPES record last updated Feb 15, 2022
Key facts
- NPI
- 1154076479
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- HEALTHSTAR PHYSICIANS OF HOT SPRINGS, PLLC
- Practice address
- 1661 Airport Rd Ste D
Hot Springs, AR 71913-8184 - Phone
- (501) 625-7500
- Fax
- (501) 625-7777
- NPI assigned
- Feb 15, 2022
- Organization subpart
- No
Authorized official
- Name
- Brenda Larie Southerland
- Title
- Cfo
- Phone
- (501) 625-7500
Other NPIs on the same Medicare enrollment 15
Corporate family (same tax ID) 11
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040315001542 | AR | Part B Supplier - Clinic/Group Practice | 5698665685 |
Receives reassigned benefits from 92 practitioners 25 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Amity, AR; Hot Springs, AR; Norman, AR; Pearcy, AR; Poyen, AR |
National Provider Directory
- Tax ID family
- West Shore Medical Clin
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
1661 Airport Rd Ste D
Hot Springs, AR 71913-8184
Mailing address
1661 Airport Rd Ste D
Hot Springs, AR 71913-8184
Phone (501) 625-7500
Other names
- HealthStar PM Billing Services
NPI Registry JSON
{
"created_epoch": "1644883200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1644883200000",
"number": "1154076479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1661 AIRPORT RD STE D",
"city": "HOT SPRINGS",
"state": "AR",
"postal_code": "719138184",
"telephone_number": "501-625-7500",
"fax_number": "501-625-7777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1661 AIRPORT RD STE D",
"city": "HOT SPRINGS",
"state": "AR",
"postal_code": "719138184",
"telephone_number": "501-625-7500",
"fax_number": "501-625-7777"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEALTHSTAR PHYSICIANS OF HOT SPRINGS, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-02-15",
"last_updated": "2022-02-15",
"certification_date": "2022-02-15",
"status": "A",
"authorized_official_last_name": "SOUTHERLAND",
"authorized_official_first_name": "BRENDA",
"authorized_official_middle_name": "LARIE",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "501-625-7500"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "HealthStar PM Billing Services",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Hot Springs, AR
- Healthfirst Physicians of Arkansas PA
- Healthfirst Physicians of Arkansas, P. a.
- Healthfirst Physicians of Arkansas, P.a.
- Healthfirst Physicians of Arkansas, PA
- Healthstar Physicians of Hot Springs, PLLC
- Healthstar Physicians of Hot Springs, PLLC
- Healthstar Physicians of Hot Springs, PLLC
- Healthstar Physicians of Hot Springs, PLLC
- Healthstar Physicians of Hot Springs, PLLC
- Healthstar Physicians of Hot Springs, PLLC
All providers in Hot Springs, AR · Family Medicine 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 15, 2022. 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.