White River Health System, Inc.
Organization Active NPI Multi-Specialty Clinic/Center · Cherokee Village, AR
NPI 1457904005 · NPPES record last updated May 2, 2024
Key facts
- NPI
- 1457904005
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- WHITE RIVER HEALTH SYSTEM, INC.
- Practice address
- 195 Hospital Dr Ste C
Cherokee Village, AR 72529-7330 - Phone
- (870) 257-6040
- Fax
- (870) 257-6666
- NPI assigned
- Jul 23, 2019
- Organization subpart
- No
Authorized official
- Name
- Shawna Baxter
- Title
- Provider Enrollment
- Phone
- (870) 262-5545
Other NPIs on the same Medicare enrollment 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170119000552 | AR | Part B Supplier - Clinic/Group Practice | 0143134270 |
Receives reassigned benefits from 24 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Southside, AR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
195 Hospital Dr Ste C
Cherokee Village, AR 72529-7330
Mailing address
1710 Harrison St
Batesville, AR 72501-7303
Phone (870) 257-6040
Other names
- WRMC Medical Complex Cherokee Village Specialty Clinic
Other providers in Cherokee Village, AR
- United Methodist Behavioral Health System, Inc
- Urban Medical Clinic
- White River Health System Inc.
- White River Health System, Inc.
- White River Health System, Inc.
- White River Health System, Inc.
- White River Health System, Inc.
- White River Health System, Inc.
- White River Health System,Inc.
- Kathleen Ann Williams
All providers in Cherokee Village, AR · Multi-Specialty Clinic/Center 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 2, 2024. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.