Active NPI
Gravette Medical Center Hospital
- Critical Access Hospital
- Gravette, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Access Hospital
- License
- AR4284
- Legal business name
- GRAVETTE MEDICAL CENTER HOSPITAL
- Practice address
- 1101 Jackson St SW
Gravette, AR 72736-9121 - Phone
- (479) 787-5291
- Fax
- (479) 787-7890
- NPI assigned
- Dec 4, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. William Sparks
- Title
- Interim Ceo
- Phone
- (479) 787-5291
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | AR4284 | AR | Primary |
Addresses
Primary practice location
1101 Jackson St SW
Gravette, AR 72736-9121
Mailing address
PO Box 450
Gravette, AR 72736-0450
Phone (479) 787-5291
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI to CCN mapping 2
The Medicare certification numbers (CCNs) connected to NPI 1295893220. Details of each certification follow.
Hospital certification: CCN 040075
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- GRAVETTE MEDICAL CENTER
- Certification status
- Terminated Voluntary: merger or closure, May 31, 2005
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1971
- Last certification
- Feb 17, 2005
- Beds
- 50
- Ownership / control type
- Other
- Facility address
- 1101 Jackson Street SW
Gravette, AR 72736
Hospital certification: CCN 041325
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- GRAVETTE MEDICAL CENTER HOSPITAL
- Certification status
- Terminated Voluntary: merger or closure, Sep 7, 2005
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Jun 1, 2005
- Last certification
- Jun 1, 2005
- Beds
- 25
- Ownership / control type
- Other
- Facility address
- 1101 Jackson Street, SW
Gravette, AR 72736
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
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.
-
- Certified Registered Nurse Anesthetist
- Wichita, KS
- NPI 1376513135
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1295893220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 450",
"city": "GRAVETTE",
"state": "AR",
"postal_code": "727360450",
"telephone_number": "479-787-5291",
"fax_number": "479-787-7890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 JACKSON ST SW",
"city": "GRAVETTE",
"state": "AR",
"postal_code": "727369121",
"telephone_number": "479-787-5291",
"fax_number": "479-787-7890"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRAVETTE MEDICAL CENTER HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-04",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SPARKS",
"authorized_official_first_name": "WILLIAM",
"authorized_official_title_or_position": "INTERIM CEO",
"authorized_official_telephone_number": "479-787-5291",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "282NC0060X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital, Critical Access",
"state": "AR",
"license": "AR4284",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gravette, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.