Howard Memorial Hospital
Organization Active NPI Surgery Physician · Nashville, AR
NPI 1215102702 · NPPES record last updated Dec 18, 2019
Key facts
- NPI
- 1215102702
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- HOWARD MEMORIAL HOSPITAL
- Practice address
- 130 Medical Circle
Nashville, AR 71852 - Phone
- (870) 845-8024
- Fax
- (870) 845-8027
- NPI assigned
- Apr 25, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- HOWARD MEMORIAL HOSPITAL
Authorized official
- Name
- Mrs. Kaitlyn Gunn
- Title
- Clinic Financial Director
- Phone
- (870) 845-6051
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 9
Practitioners 16
-
John E Hearnsberger, M.D.
-
Mark Edward Sutherland, M.D.
-
Alana Kaye Day, APRN
-
Jayla Rose Jacques, MS, CCC-SLP
-
Charles Brian Caldwell, M.D.
-
Fawad H Walajahi, M.D.
-
Amy Karen Davis, FNP
-
Joni D McGhee, OT
-
Tugi Renee Myers, NP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Elite Home Health |
Home health agency | 5% Or Greater Direct Ownership Interest (33%) | Jul 16, 2007 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051221000476 | AR | Part B Supplier - Clinic/Group Practice | 7315851599 |
Receives reassigned benefits from 8 practitioners Practice locations: Nashville, AR |
National Provider Directory
- Tax ID family
- Howard Memorial Hospita
- Part of
- Howard Memorial Hospita
Locations
130 Medical Cir
Ste 100
Nashville, AR 71852
132 Medical Cir
Nashville, AR 71852
Phone (870) 845-4400
1315 S 4th St
Nashville, AR 71852
Phone (870) 845-8161
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | Yes |
Addresses
Primary practice location
130 Medical Circle
Nashville, AR 71852
Mailing address
130 Medical Circle
Nashville, AR 71852
Phone (870) 845-8024
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 57969 | Other | AR | BLUE CROSS |
Other names
- Physician's Group
Other providers in Nashville, AR
- Janie Hoover
- Howard County Ambulance Service
- Howard County Childrens Center Inc
- Howard County Childrens Center Inc
- Howard Memorial Hospital
- Howard Memorial Hospital
- Howard Memorial Hospital
- Howard Memorial Hospital
- Howard Memorial Hospital
- Howard Memorial Hospital
All providers in Nashville, AR · Surgery 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 Dec 18, 2019. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.