NPIMap

Organization Active NPI

Healthstar Physicians of Hot Springs, PLLC

Doing business as Lake Hamilton Family Medicine

  • Family Medicine Physician
  • Hot Springs, AR
National Provider Identifier
1376884692
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HEALTHSTAR PHYSICIANS OF HOT SPRINGS, PLLC
Doing business as
Lake Hamilton Family Medicine
Practice address
1661 Airport Rd Ste F
Hot Springs, AR 71913-8184
Phone
(501) 651-4300
Fax
(501) 651-4318
NPI assigned
Mar 12, 2013
Last updated
Apr 3, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Authorized official

Name
Ms. Brenda Larie Southerland
Title
Business Office Manager
Phone
(501) 625-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1661 Airport Rd Ste F
Hot Springs, AR 71913-8184

Mailing address

1661 Airport Rd
Suite D
Hot Springs, AR 71913-7951
Phone (501) 625-7500

Other names 1

  • Lake Hamilton Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315001542 AR Part B Supplier - Clinic/Group Practice 5698665685 Receives reassigned benefits from 92 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Amity, AR; Hot Springs, AR; Norman, AR; Pearcy, AR; Poyen, AR

Other NPIs on the same Medicare enrollment 15

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

View all 15

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
04D2057827Lake Hamilton Family Medicine1661 Airport Rd Suite F, Hot Springs, AR 71913ComplianceApr 16, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522713600000",
    "number": "1376884692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 AIRPORT RD",
            "address_2": "SUITE D",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719137951",
            "telephone_number": "501-625-7500",
            "fax_number": "501-625-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 AIRPORT RD STE F",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719138184",
            "telephone_number": "501-651-4300",
            "fax_number": "501-651-4318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSTAR PHYSICIANS OF HOT SPRINGS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-12",
        "last_updated": "2018-04-03",
        "status": "A",
        "authorized_official_last_name": "SOUTHERLAND",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "LARIE",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "501-625-7500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Hamilton Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hot Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; 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.