Baxter Regional Health System

Organization Active NPI Family Nurse Practitioner · Melbourne, AR

NPI 1154849065 · NPPES record last updated May 13, 2025

Key facts

NPI
1154849065
Entity type
Organization (NPI type 2)
Primary specialty
Family Nurse Practitioner 363LF0000X
Legal business name
BAXTER REGIONAL HEALTH SYSTEM
Practice address
1019 East Main Street
Melbourne, AR 72556
Phone
(870) 916-2150
NPI assigned
Aug 31, 2017
Organization subpart
No

Authorized official

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

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 8

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

Other NPIs with the same Medicare PAC ID 2

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

Corporate family (same tax ID) 7

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

Practitioners 20

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AR

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Baxter Health Fulton County Hospital
Salem, AR · CCN 041322
Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Dec 31, 2024
Dec 31, 2024
Baxter Health
Salem, AR · CCN 04Z322
Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Dec 31, 2024
Dec 31, 2024
Baxter Health Fulton County Family Clinic
Salem, AR · CCN 048552
Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2025

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20160324000353 AR Part B Supplier - Clinic/Group Practice 0941507677 Receives reassigned benefits from 20 practitioners
8 other NPIs on this enrollment
Practice locations: Melbourne, AR; Harrison, AR; Mountain Home, AR; Mountain View, AR; Pocahontas, AR; Salem, AR; Mammoth Spring, AR; Cave City, AR…

National Provider Directory

Tax ID family
Baxter Regional Health System (8 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LF0000X Yes

Addresses

Primary practice location

1019 East Main Street
Melbourne, AR 72556

Mailing address

1019 East Main Street
Melbourne, AR 72556
Phone (870) 916-2150

Other names

  • Baxter Health Family Clinic at Melbourne Doing business as

Other providers in Melbourne, AR

All providers in Melbourne, AR · Family Nurse Practitioner in Arkansas

Sources for this page

Verify at the official NPI Registry.