Baptist Health

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

BAPTIST HEALTH

Doing business as

Baptist Health Family Clinic - Malvern

Practice address

1234 S Main St
Malvern, AR 72104-5226

Phone

(501) 337-9066

NPI assigned

Mar 14, 2022

Last updated

Mar 14, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Troy Wells

Title

President

Phone

(501) 202-2080

Specialties & licenses 1

Addresses

Other names 1

• Baptist Health Family Clinic - Malvern Doing business as

Medicare fee-for-service enrollment

Enrolled in AR2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477201937. Details of each certification follow.

• CCN 048535 Rural health clinic · Active · Details

Rural health clinic certification: CCN 048535

Legal name

BAPTIST HEALTH

Doing business as

BAPTIST HEALTH FAMILY CLINIC - MALVERN

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Sep 14, 2022

Last certification

Jun 2, 2025

Ownership / control type

2B

Organization structure

CorporationNon-profit

Incorporated

Oct 1, 1920 in AR

Enrollment address

1234 S Main St
Malvern, AR 72104-5226

Related CCNs

040076

Related certifications (CCN) 1

Facilities connected through Provider of Services related, parent or unit certification numbers.

• Baptist Health

  dba Baptist Health Medical Center- Hot Spring County

  • General Acute Care Hospital
  • Malvern, AR
  • NPI 1902868391

  Parent provider

  Provider of Services

Other NPIs on the same Medicare enrollment 8

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

• Baptist Health

  dba Baptist Health Family Clinic - Sheridan

  • Rural Health Clinic/Center
  • Sheridan, AR
  • NPI 1114792157

  O20210504000413

  Same enrollment
• Baptist Health

  dba Baptist Health Family Clinic - Beebe

  • Rural Health Clinic/Center
  • Beebe, AR
  • NPI 1376336883

  O20210504000413

  Same enrollment
• Baptist Health

  dba Baptist Health Family Clinic - Sparkman

  • Rural Health Clinic/Center
  • Sparkman, AR
  • NPI 1427630110

  O20210504000413

  Same enrollment
• Baptist Health

  dba Baptist Health - UAMS Cancer Clinic

  • Multi-Specialty Clinic/Center
  • Little Rock, AR
  • NPI 1487363099

  O20210504000413

  Same enrollment
• Baptist Health

  dba Baptist Health Family Clinic - Russellville

  • Rural Health Clinic/Center
  • Russellville, AR
  • NPI 1689467102

  O20210504000413

  Same enrollment
• Baptist Health

  dba Baptist Health Family Clinic - Perryville

  • Rural Health Clinic/Center
  • Perryville, AR
  • NPI 1790578219

  O20210504000413

  Same enrollment
• Baptist Health

  dba Baptist Health Cancer Clinic - Drew County

  • Medical Oncology Physician
  • Monticello, AR
  • NPI 1861266793

  O20210504000413

  Same enrollment
• Baptist Health

  dba BH Cancer Center - Heber Springs

  • Multi-Specialty Clinic/Center
  • Heber Springs, AR
  • NPI 1932081221

  O20210504000413

  Same enrollment

Tax ID family

Emergency Specialists-a59 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Baptist Health

  dba Baptist Home Health Network

  • Home Health Agency
  • Little Rock, AR
  • NPI 1134225451
  NPD tax ID
• Baptist Health

  dba Baptist Hospice

  • Community Based Hospice Care Agency
  • Little Rock, AR
  • NPI 1164526554
  NPD tax ID
• Baptist Health

  dba Baptist Health Medical Center-Arkadelphia

  • Critical Access Hospital
  • Arkadelphia, AR
  • NPI 1174553796
  NPD tax ID
• Baptist Health

  dba Baptist Health Rehabilitation Institute

  • Rehabilitation Hospital
  • Little Rock, AR
  • NPI 1215967831
  NPD tax ID
• Baptist Health

  dba Baptist Medical Center-Psych

  • Psychiatric Hospital Unit
  • Little Rock, AR
  • NPI 1255377420
  NPD tax ID
• Baptist Health

  dba Baptist Health Medical Center - Magnolia

  • Medicare Defined Swing Bed Hospital Unit
  • Magnolia, AR
  • NPI 1295631893
  NPD tax ID
• Baptist Health

  dba Baptist Health Ouachita Valley Family Clinic

  • Rural Health Clinic/Center
  • Camden, AR
  • NPI 1366279424
  NPD tax ID
• Baptist Health

  dba Baptist Health Family Clinic - Beebe

  • Rural Health Clinic/Center
  • Beebe, AR
  • NPI 1376336883
  NPD tax ID
• Baptist Health

  dba Baptist Health Family Clinic - Gurdon

  • Primary Care Clinic/Center
  • Gurdon, AR
  • NPI 1396080552
  NPD tax ID
• Baptist Health

  dba Baptist Health Medical Center - Magnolia

  • Critical Access Hospital
  • Magnolia, AR
  • NPI 1417893223
  NPD tax ID
• Baptist Health

  dba Baptist Health Family Clinic - Sparkman

  • Rural Health Clinic/Center
  • Sparkman, AR
  • NPI 1427630110
  NPD tax ID
• Baptist Health

  dba Baptist Hospice

  • Community Based Hospice Care Agency
  • Arkadelphia, AR
  • NPI 1477658839
  NPD tax ID

Locations

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

All facility ownership & control disclosures 50

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Facilities with the same owner 50

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Baptist Health

  dba Baptist Health Family Clinic Greers Ferry

  • Rural Health Clinic/Center
  • Greers Ferry, AR
  • NPI 1003821703

  Baptist Health

  CMS ownership
• Baptist Health

  dba Baptist Home Health Network

  • Home Health Agency
  • Heber Springs, AR
  • NPI 1033213632

  Baptist Health

  CMS ownership
• Baptist Health

  dba Baptist Health Medical Center-Little Rock

  • General Acute Care Hospital
  • Little Rock, AR
  • NPI 1043240682

  Baptist Health

  CMS ownership
• Baptist Health

  • Rural Health Clinic/Center
  • Heber Springs, AR
  • NPI 1104268689

  Baptist Health

  CMS ownership
• Baptist Health

  dba Baptist Health Family Clinic - Sheridan

  • Rural Health Clinic/Center
  • Sheridan, AR
  • NPI 1114792157

  Baptist Health

  CMS ownership
• Baptist Health

  dba Baptist Home Health Network

  • Home Health Agency
  • Little Rock, AR
  • NPI 1134225451

  Baptist Health

  CMS ownership
• Baptist Health

  dba Baptist Hospice

  • Community Based Hospice Care Agency
  • Little Rock, AR
  • NPI 1164526554

  Baptist Health

  CMS ownership
• Baptist Health

  dba Baptist Health Medical Center-Arkadelphia

  • Critical Access Hospital
  • Arkadelphia, AR
  • NPI 1174553796

  Baptist Health

  CMS ownership
• Baptist Health

  dba Baptist Health Rehabilitation Institute

  • Rehabilitation Hospital
  • Little Rock, AR
  • NPI 1215967831

  Baptist Health

  CMS ownership
• Baptist Health

  dba Baptist Medical Center-Psych

  • Psychiatric Hospital Unit
  • Little Rock, AR
  • NPI 1255377420

  Baptist Health

  CMS ownership
• Baptist Health

  dba Baptist Health Ouachita Valley Family Clinic

  • Rural Health Clinic/Center
  • Camden, AR
  • NPI 1366279424

  Baptist Health

  CMS ownership
• Baptist Health

  dba Baptist Health Family Clinic - Beebe

  • Rural Health Clinic/Center
  • Beebe, AR
  • NPI 1376336883

  Baptist Health

  CMS ownership

Practitioners 5

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.

• Altimus Ray Bollen, M.D.

  • Internal Medicine Physician
  • Malvern, AR
  • NPI 1720054125
  NPD
• Brian Campbell Jimenez, M.D.

  • Hematology & Oncology Physician
  • Pine Bluff, AR
  • NPI 1548668916
  NPD
• Leslie Collie, APRN

  • Family Nurse Practitioner
  • Arkadelphia, AR
  • NPI 1679211734
  NPD
• Heather Grigsby, APRN

  • Family Nurse Practitioner
  • Malvern, AR
  • NPI 1881002756
  NPD
• Laura L Lester, M.D.

  • Family Medicine Physician
  • Fayetteville, AR
  • NPI 1568801447
  NPD

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1477201937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 BAPTIST HEALTH DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056321",
            "telephone_number": "501-202-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 S MAIN ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721045226",
            "telephone_number": "501-337-9066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-202-2080"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Health Family Clinic - Malvern",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sourou Alban Awadjihe, RN
• Courtney Bacon-Latina, LPC
• Cody Bailey, RECOVERY ASSISTANT
• Aleah Banks
• Baptist Health (Baptist Health Home Health Netword- Hot Spring County)
• Baptist Health (Baptist Health Medical Center - Hot Spring County)
• Baptist Health (Baptist Health Medical Center- Hot Spring County)
• Enrique Barban Martinez
• Barbara Lazerus Crna Ms
• Ryver Barham

• Rural Health Clinic/Center in Malvern, AR
• Providers in Malvern, AR by specialty
• Rural Health Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.

Verify at the official NPI Registry.