NPIMap

Organization Active NPI

Howard Memorial Hospital

Doing business as Physician's Group

  • Surgery Physician
  • Nashville, AR
National Provider Identifier
1215102702
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
HOWARD MEMORIAL HOSPITAL
Doing business as
Physician's Group
Practice address
130 Medical Circle
Nashville, AR 71852
Phone
(870) 845-8024
Fax
(870) 845-8027
NPI assigned
Apr 25, 2008
Last updated
Dec 18, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
HOWARD MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Authorized official

Name
Mrs. Kaitlyn Gunn
Title
Clinic Financial Director
Phone
(870) 845-6051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

130 Medical Circle
Nashville, AR 71852

Mailing address

130 Medical Circle
Nashville, AR 71852
Phone (870) 845-8024

Other identifiers 1

IdentifierTypeStateIssuer
57969OtherARBLUE CROSS

Other names 1

  • Physician's Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051221000476 AR Part B Supplier - Clinic/Group Practice 7315851599 Receives reassigned benefits from 8 practitioners
Practice locations: Nashville, AR

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Howard Memorial Hospital12 organizations share this tax ID, including this one
Part of
Howard Memorial Hospital

Other organizations with this tax ID 11

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

Locations

130 Medical Cir
Ste 100
Nashville, AR 71852

132 Medical Cir
Ste 200
Nashville, AR 71852
Phone (870) 845-3757

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Elite Home HealthNashville, AR, CCN 047138 Home health agency 5% Or Greater Direct Ownership Interest (33%) Jul 16, 2007

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 12

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": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576627200000",
    "number": "1215102702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 MEDICAL CIRCLE",
            "city": "NASHVILLE",
            "state": "AR",
            "postal_code": "71852",
            "telephone_number": "870-845-8024",
            "fax_number": "870-845-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 MEDICAL CIRCLE",
            "city": "NASHVILLE",
            "state": "AR",
            "postal_code": "71852",
            "telephone_number": "870-845-8024",
            "fax_number": "870-845-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOWARD MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOWARD MEMORIAL HOSPITAL",
        "enumeration_date": "2008-04-25",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A",
        "authorized_official_last_name": "GUNN",
        "authorized_official_first_name": "KAITLYN",
        "authorized_official_title_or_position": "CLINIC FINANCIAL DIRECTOR",
        "authorized_official_telephone_number": "870-845-6051",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "57969",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physician's Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nashville, AR

Sources for this page

Verify at the official NPI Registry.