NPIMap

Organization Active NPI

White River Health System, Inc.

Doing business as Batesville Family Care

  • Rural Health Clinic/Center
  • Batesville, AR
National Provider Identifier
1154770436
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
WHITE RIVER HEALTH SYSTEM, INC.
Doing business as
Batesville Family Care
Practice address
1215 Sidney St
Ste 300
Batesville, AR 72501-7203
Phone
(870) 793-1126
Fax
(870) 793-1180
NPI assigned
Jun 8, 2016
Last updated
Apr 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Authorized official

Name
Mr. Gary Paxson
Title
Cio
Phone
(870) 262-1960

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1215 Sidney St
Ste 300
Batesville, AR 72501-7203

Mailing address

1215 Sidney St
Ste 300
Batesville, AR 72501-7203
Phone (870) 793-1126

Other names 1

  • Batesville Family Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040216000496 AR Part A Provider - Hospital 0143134270 16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Batesville, AR; Mountain View, AR; Cherokee Village, AR
O20170216001323 AR Part B Supplier - Clinic/Group Practice 0143134270 Receives reassigned benefits from 34 practitioners
Practice locations: Batesville, AR
O20230615003217 AR Part A Provider - Rural Health Clinic 0143134270 Practice locations: Batesville, AR

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1154770436. Details of each certification follow.

Hospital certification: CCN 040119

Legal name
WHITE RIVER HEALTH SYSTEM, INC.
Doing business as
WHITE RIVER MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jan 30, 1976
Last certification
Apr 6, 2023
Beds
224
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jan 31, 1976 in AR
Enrollment address
1710 Harrison St
White River Medical Center
Batesville, AR 72501-7303
Main/Primary Hospital Location
Hospital subgroups
Acute care

Rural health clinic certification: CCN 048542

Legal name
WHITE RIVER HEALTH SYSTEM, INC.
Doing business as
WHITE RIVER HEALTH CARE FAMILY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 6, 2023
Last certification
Dec 6, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Aug 17, 1999 in AR
Enrollment address
1215 Sidney St
Ste 300
Batesville, AR 72501-7201
Related CCNs
040119

Facilities connected through Provider of Services related, parent or unit certification numbers.

View all 26

Other NPIs on the same Medicare enrollment 15

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

View all 15

Care Compare: Hospital

Medicare Care Compare
Listed as
White River Medical CenterCCN 040119 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D0468209White River Health Family Care1215 Sidney Street, Suite 300, Batesville, AR 72501Certificate of waiverJan 23, 2027

National Provider Directory

National Provider Directory

Locations

195 Hospital Dr
Ste B
Cherokee Vlg, AR 72529
Phone (870) 257-6000

Ownership & related parties

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Crystal Johnson Individual Corporate DirectorBoard Member Jan 1, 2025
White River Health System, Inc. Organization, Batesville, AR Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 31, 1976
Operational/Managerial Control Jan 31, 1976
5% Or Greater Direct Ownership Interest Jun 1, 2023 100%
Steve Case Individual Corporate DirectorBoard Member Jan 1, 2025
Corporate OfficerBoard Member Jun 1, 2023
Stacy Gunderman Individual Corporate DirectorBoard Member Jan 1, 2025
Maggie Williams Individual Corporate DirectorExecutive Director Jan 1, 2025
Danny Bell Individual Corporate DirectorBoard Member Jan 1, 2025
Robert McIntire Individual Corporate DirectorTreasurer Jan 1, 2025
Corporate OfficerBoard Member Jun 1, 2023
Elizabeth Christian Individual Corporate DirectorBoard Member Jan 1, 2025
Jason Taylor Individual Corporate DirectorBoard Member Jan 1, 2025
Corporate OfficerBoard Member Jun 1, 2023
Tina Wheelis Individual Corporate DirectorBoard Member Jan 1, 2025
Corporate OfficerBoard Member Jun 1, 2023
Jeff Showalter Individual Corporate DirectorSecretary Jan 1, 2025
Corporate OfficerBoard Member Jun 1, 2023
Shawna Baxter Individual W-2 Managing EmployeeProvider Enrollment Specialist Aug 28, 2023
Kevin S Rose Individual Corporate DirectorBoard Member Jan 1, 2025
Corporate OfficerBoard Member Jun 1, 2023
Randy Cross Individual Corporate DirectorChair Jan 1, 2025
Corporate OfficerBoard Member Jun 1, 2023
Kathy Lanier Individual Corporate DirectorBoard Member Jan 1, 2025
Lisa Lambert Individual Corporate DirectorExecutive Director Jan 1, 2024
William Tyler Fowlkes Individual Corporate DirectorVice Chair Jan 1, 2025
Corporate OfficerBoard Member Jun 1, 2023
Lance Lamberth Individual Corporate DirectorBoard Member Jan 1, 2025
Philip Brissey Individual Corporate OfficerBoard Member Jun 1, 2023
Rick Elumbaugh Individual Corporate OfficerBoard Member Jun 1, 2023
Paula Terrell Individual Corporate OfficerBoard Member Jun 1, 2023
Heather Billingsley Individual W-2 Managing EmployeeContract Compliance Specialist Jun 1, 2023
Robert Wright Individual Corporate OfficerAdministrator Jun 1, 2023
Corporate DirectorAdministrator Jun 1, 2023
W-2 Managing EmployeeAdministrator Jun 1, 2023

All facility ownership & control disclosures 16

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
White River Medical CenterBatesville, AR, CCN 040119 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jan 31, 1976
Jan 31, 1976
Stone County Medical CenterMountain View, AR, CCN 041310 Hospital Operational/Managerial Control Jan 1, 2008
Stone County Medical CenterMountain View, AR, CCN 04Z310 Hospital 5% Or Greater Direct Ownership Interest Apr 1, 1999
White River Medical CenterBatesville, AR, CCN 04S119 Hospital Operational/Managerial Control Dec 21, 2007
White River Medical Center Rehabilitation UnitBatesville, AR, CCN 04T119 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1976
Midway Medical ClinicCherokee Village, AR, CCN 043981 Rural health clinic Operational/Managerial Control (100%) Sep 10, 2010
Melbourne Medical ClinicMelbourne, AR, CCN 043997 Rural health clinic Operational/Managerial Control Oct 16, 2007
Drasco Medical ClinicDrasco, AR, CCN 043455 Rural health clinic 5% Or Greater Direct Ownership Interest Jul 12, 1996
Cave City Medical ClinicCave City, AR, CCN 043982 Rural health clinic Operational/Managerial Control Nov 19, 1991
Plesant Plains Medical ClinicPleasant Plains, AR, CCN 043422 Rural health clinic Operational/Managerial Control Jul 1, 2006
White River Health Family CareMountain View, AR, CCN 043884 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2015
Sugarloaf Medical ClinicHeber Springs, AR, CCN 043914 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2021
White River Health Family CareNewark, AR, CCN 048540 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2023
White River Health Family CareBatesville, AR, CCN 048539 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2023
White River Health Family CareSouthside, AR, CCN 048541 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2023
White River Health Children's ClinicBatesville, AR, CCN 048543 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2023

Facilities with the same owner 16

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 16

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

Affiliated clinicians 353

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 353

NPI Registry JSON

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1154770436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 SIDNEY ST",
            "address_2": "STE 300",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017203",
            "telephone_number": "870-793-1126",
            "fax_number": "870-793-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 SIDNEY ST",
            "address_2": "STE 300",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017203",
            "telephone_number": "870-793-1126",
            "fax_number": "870-793-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE RIVER HEALTH SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-08",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "PAXSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CIO",
        "authorized_official_telephone_number": "870-262-1960",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Batesville Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Batesville, AR

Sources for this page

Verify at the official NPI Registry.