NPIMap

Organization Active NPI

Baxter Regional Enterprises, LLC

Doing business as Baxter Regional Cardiovascular Clinic

  • Specialist
  • Mountain Home, AR
National Provider Identifier
1265197651
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
BAXTER REGIONAL ENTERPRISES, LLC
Doing business as
Baxter Regional Cardiovascular Clinic
Practice address
555 W 6TH St
Mountain Home, AR 72653-3409
Phone
(870) 425-8288
NPI assigned
Nov 1, 2021
Last updated
Nov 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Authorized official

Name
Lucinda Crow
Title
System Data Analyst
Phone
(870) 508-1081

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

555 W 6TH St
Mountain Home, AR 72653-3409

Mailing address

555 W 6TH St
Mountain Home, AR 72653-3409

Other names 1

  • Baxter Regional Cardiovascular Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address benjamin.stevens@bhcawp.eclinicaldirectplus.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220121001564 AR Part B Supplier - Clinic/Group Practice 3476945528 Receives reassigned benefits from 18 practitioners
2 other NPIs on this enrollment
Practice locations: Salem, AR; Mountain View, AR; Mountain Home, AR; Harrison, AR; Ash Flat, AR

Other NPIs on the same Medicare enrollment 2

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D1030816Baxter Regional Cardiovascular Clinic555 West 6TH Street, Mountain Home, AR 72653Certificate of waiverSep 16, 2026

National Provider Directory

National Provider Directory
Tax ID family
Baxter Co Reg Hospital Inc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

114 E Crandall Ave
#B
Harrison, AR 72601
Phone (870) 741-8484

114 E Crandall Ave
Ste D
Harrison, AR 72601
Phone (870) 741-6065

15 Green Valley Dr
#100
Mountain Home, AR 72653
Phone (870) 701-0490

628 Hospital Dr
Ste 112
Mountain Home, AR 72653
Phone (870) 425-8288

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638230400000",
    "number": "1265197651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W 6TH ST",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W 6TH ST",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533409",
            "telephone_number": "870-425-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAXTER REGIONAL ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A",
        "authorized_official_last_name": "CROW",
        "authorized_official_first_name": "LUCINDA",
        "authorized_official_title_or_position": "SYSTEM DATA ANALYST",
        "authorized_official_telephone_number": "870-508-1081"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "benjamin.stevens@bhcawp.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "555 W 6th St",
            "city": "Mountain Home",
            "state": "AR",
            "country_code": "US",
            "postal_code": "726533409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Baxter Regional Cardiovascular Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baxter Regional Cardiovascular Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mountain Home, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.