Baxter Regional Health System
Organization Active NPI Family Medicine Physician · Harrison, AR
NPI 1356976047 · NPPES record last updated May 4, 2023
Key facts
- NPI
- 1356976047
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- BAXTER REGIONAL HEALTH SYSTEM
- Practice address
- 406 N Willow St
Harrison, AR 72601-3517 - Phone
- (870) 741-3252
- NPI assigned
- Mar 3, 2020
- Organization subpart
- No
Authorized official
- Name
- Debra Henry
- Title
- Cfo
- Phone
- (870) 508-1003
Other NPIs on the same Medicare enrollment 8
Corporate family (same tax ID) 7
Practitioners 3
-
Stacy L Armstrong, D.O.
-
Victor M. Armstrong, D.O.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D2187783 | Baxter Health Willow Street Family Clinic | Certificate of waiver | Jul 7, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160324000353 | AR | Part B Supplier - Clinic/Group Practice | 0941507677 |
Receives reassigned benefits from 20 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Melbourne, AR; Harrison, AR; Mountain Home, AR; Mountain View, AR; Pocahontas, AR; Salem, AR; Mammoth Spring, AR; Cave City, AR… |
National Provider Directory
- Tax ID family
- Baxter Regional Health System
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
406 N Willow St
Harrison, AR 72601-3517
Mailing address
406 N Willow St
Harrison, AR 72601-3517
Other names
- Baxter Health Willow Street Family Clinic
Other providers in Harrison, AR
- Baxter County Regional Hospital, Inc
- Baxter County Regional Hospital, Inc
- Baxter Health Ambulatory Surgery Center, LLC
- Baxter Regional Enterprises, LLC
- Baxter Regional Health System
- Baxter Regional Health System
- Laini Marie Beans
- Stephen A. Beeler
- Kristin Beightol
- Christopher Bennett
All providers in Harrison, AR · Family Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.