NPIMap

Organization Active NPI

Five Rivers Medical Center Inc.

Doing business as Five Rivers Medical Center Emergency Physician Professional Services

  • Emergency Medicine Physician
  • Pocahontas, AR
National Provider Identifier
1245071620
Registry record updated Jun 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
FIVE RIVERS MEDICAL CENTER INC.
Doing business as
Five Rivers Medical Center Emergency Physician Professional Services
Practice address
2801 Medical Center Dr
Pocahontas, AR 72455-9436
Phone
(870) 892-6000
Fax
(870) 892-6258
NPI assigned
Jun 1, 2024
Last updated
Jun 1, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
FIVE RIVERS MEDICAL CENTER INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2024

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

Authorized official

Name
Randall Dewayne Barymon
Title
Ceo
Phone
(870) 892-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

2801 Medical Center Dr
Pocahontas, AR 72455-9436

Mailing address

2801 Medical Center Dr
Pocahontas, AR 72455-9436
Phone (870) 892-6000

Other names 1

  • Five Rivers Medical Center Emergency Physician Professional Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110321000471 AR Part B Supplier - Clinic/Group Practice 1456540194 Receives reassigned benefits from 67 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pocahontas, AR

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Five Rivers Medical Center Inc8 organizations share this tax ID, including this one
Part of
Five Rivers Medical Center Inc

Other organizations with this tax ID 7

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 9

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": "1717200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717200000000",
    "number": "1245071620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 MEDICAL CENTER DR",
            "city": "POCAHONTAS",
            "state": "AR",
            "postal_code": "724559436",
            "telephone_number": "870-892-6000",
            "fax_number": "870-892-6258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 MEDICAL CENTER DR",
            "city": "POCAHONTAS",
            "state": "AR",
            "postal_code": "724559436",
            "telephone_number": "870-892-6000",
            "fax_number": "870-892-6258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE RIVERS MEDICAL CENTER INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE RIVERS MEDICAL CENTER INC.",
        "enumeration_date": "2024-06-01",
        "last_updated": "2024-06-01",
        "certification_date": "2024-06-01",
        "status": "A",
        "authorized_official_last_name": "BARYMON",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "DEWAYNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-892-6200"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Five Rivers Medical Center Emergency Physician Professional Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pocahontas, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2024; 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.