NPIMap

Organization Active NPI

Healthstar Physicians of Hot Springs, PLLC

Doing business as West Gate Family Medicine

  • Family Medicine Physician
  • Hot Springs, AR
National Provider Identifier
1174976492
Registry record updated Apr 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HEALTHSTAR PHYSICIANS OF HOT SPRINGS, PLLC
Doing business as
West Gate Family Medicine
Practice address
2266 Albert Pike Rd
Hot Springs, AR 71913-4003
Phone
(501) 767-1144
Fax
(501) 767-4455
NPI assigned
Jul 21, 2016
Last updated
Apr 4, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2018

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

Authorized official

Name
Brenda Larie Southerland
Title
Business Office Manager
Phone
(501) 625-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

2266 Albert Pike Rd
Hot Springs, AR 71913-4003

Mailing address

1661 Airport Rd
Suite D
Hot Springs, AR 71913-7951
Phone (501) 625-7500

Other identifiers 1

IdentifierTypeStateIssuer
220808002MedicaidAR

Other names 1

  • West Gate Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Healthstar Physicians O12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Practitioners & affiliated clinicians

Practitioners 7

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": "1469059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522800000000",
    "number": "1174976492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 AIRPORT RD",
            "address_2": "SUITE D",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719137951",
            "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": "2266 ALBERT PIKE RD",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719134003",
            "telephone_number": "501-767-1144",
            "fax_number": "501-767-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSTAR PHYSICIANS OF HOT SPRINGS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-21",
        "last_updated": "2018-04-04",
        "status": "A",
        "authorized_official_last_name": "SOUTHERLAND",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "LARIE",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "501-625-7500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220808002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Gate Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Gate Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hot Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; 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.