NPIMap

Organization Active NPI

Bradley County Medical Center

  • Psychiatric Hospital Unit
  • Warren, AR
National Provider Identifier
1245357912
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
BRADLEY COUNTY MEDICAL CENTER
Practice address
404 S Bradley St
Warren, AR 71671-3459
Phone
(870) 226-3731
Fax
(870) 226-4300
NPI assigned
Mar 26, 2007
Last updated
Feb 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Authorized official

Name
Mrs. Leslie Huitt
Title
Ceo/Cfo
Phone
(870) 226-4301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X NU Primary

Addresses

Primary practice location

404 S Bradley St
Warren, AR 71671-3459

Mailing address

404 S Bradley St
Warren, AR 71671-3459
Phone (870) 226-3731

Other identifiers 1

IdentifierTypeStateIssuer
AR5943OtherARHOSPITAL LICENSURE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070216000407 AR Part A Provider - Critical Access Hospital 2961316112 Receives reassigned benefits from 2 practitioners
Practice locations: Warren, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245357912. Details of each certification follow.

Hospital certification: CCN 04M327

Legal name
BRADLEY COUNTY MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1997 in AR
Enrollment address
404 S Bradley St
Warren, AR 71671-3459
Hospital Psychiatric Unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Scott C Claycomb7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Joe H Wharton Individual Corporate Officer Mar 27, 2008
Bradley County Medical Center Organization, Warren, AR Corporation, Non-profit Operational/Managerial Control Jan 1, 1966 100%
Freddie M Mobley Individual Corporate Officer Sep 14, 2005
Joe Don Greenwood Individual Corporate Officer Sep 14, 2005
Belinda Gail McGhee Individual Corporate OfficerBoard of Director Mar 18, 2022
Earnest Callum Individual Corporate Officer Oct 22, 2015
Leslie Huitt Individual Corporate OfficerCeo/Cfo Dec 2, 2021 50%
W-2 Managing EmployeeCfo/Interim Ceo Dec 2, 2021 50%
Ethan Vickers Individual Corporate Officer Mar 16, 2026
Michael Milton Individual Corporate Officer Apr 17, 2023
Brenda Bryant Individual W-2 Managing EmployeeExecutive Secretary Aug 23, 2005
French Wynne Individual Corporate OfficerBoard of Director Jan 16, 2023

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Bradley County Medical CenterWarren, AR, CCN 041327 Hospital Operational/Managerial Control (100%) Jun 10, 1997
Bradley County Medical CenterWarren, AR, CCN 04Z327 Hospital Operational/Managerial Control (100%) Oct 31, 2007
Bradley County Medical Center Home Health AgencyWarren, AR, CCN 047140 Home health agency Operational/Managerial Control (100%) Jan 20, 1993
Bradley County Medical Center Rural Health ClinicWarren, AR, CCN 048518 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 1997
Oct 1, 1997

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 2

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": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1245357912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 S BRADLEY ST",
            "city": "WARREN",
            "state": "AR",
            "postal_code": "716713459",
            "telephone_number": "870-226-3731",
            "fax_number": "870-226-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 S BRADLEY ST",
            "city": "WARREN",
            "state": "AR",
            "postal_code": "716713459",
            "telephone_number": "870-226-3731",
            "fax_number": "870-226-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY COUNTY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "HUITT",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "CEO/CFO",
        "authorized_official_telephone_number": "870-226-4301",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPITAL LICENSURE",
            "identifier": "AR5943",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, AR

Sources for this page

Verify at the official NPI Registry.