Individual provider Active NPI

Hugh Hayden Hipps, CRNA

  • Certified Registered Nurse Anesthetist
  • Russellville, AR
National Provider Identifier
1194485946
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
136627 Issued in AR
Practice address
1808 W Main St
Russellville, AR 72801-2724
Phone
(479) 968-2841
NPI assigned
Dec 21, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 136627 AR Primary

Addresses

Primary practice location

1808 W Main St
Russellville, AR 72801-2724

Mailing address

2307 W 7TH St
Russellville, AR 72801-5545
Phone (479) 857-6862

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220310000585 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567857527 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Johnson Regional Medical CenterGroup PAC ID 1658360284, 16 clinicians
St Mary'S Specialty LLCGroup PAC ID 5496189318, 8 clinicians

Practice addresses (Care Compare)

1100 E Poplar St B
JRMC Anesthesia
Clarksville, AR 72830-4419
Phone (479) 754-5454

1808 W Main St
St Mary'S Anesthesia
Russellville, AR 72801-2724
Phone (479) 968-3733

Hospital & facility affiliations

  • St Marys Regional Medical Center Hospital, Russellville, AR, CCN 040041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
136627ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary'S Specialty LLC CurrentSince Jan 1, 2022 Accepting new patients
Johnson Regional Medical Center CurrentSince Jul 6, 2023 Accepting new patients
Johnson Regional Medical Center CurrentSince Jul 6, 2023 Accepting new patients

Locations

1100 E Poplar St
Ste B
Clarksville, AR 72830
Phone (479) 754-5454

1808 W Main St
Russellville, AR 72801
Phone (479) 964-4178

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1640044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1194485946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 W 7TH ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728015545",
            "telephone_number": "479-857-6862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012724",
            "telephone_number": "479-968-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIPPS",
        "first_name": "HUGH",
        "middle_name": "HAYDEN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-21",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "136627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.