Baptist Health Hospitals
Organization Active NPI Rural Health Clinic/Center · Clarendon, AR
NPI 1548468010 · NPPES record last updated Apr 2, 2025
Key facts
- NPI
- 1548468010
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- BAPTIST HEALTH HOSPITALS
- Practice address
- 198 South Main Street
Clarendon, AR 72029-2756 - Phone
- (870) 747-3349
- NPI assigned
- Jul 6, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- BAPTIST HEALTH HOSPITALS
Authorized official
- Name
- Troy Wells
- Title
- President
- Phone
- (501) 202-2080
Other NPIs with the same Medicare PAC ID 8
Corporate family (same tax ID) 6
Facilities with the same owner 50
Practitioners 5
-
Emily Neal, APRN
-
Michelle Suzanne Lusk, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D0912819 | Baptist Health Family Clinic Clarendon | Certificate of waiver | Apr 21, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Rural health clinic certification: CCN 043456
- Legal name
- BAPTIST HEALTH HOSPITALS
- Doing business as
- BAPTIST HEALTH - FAMILY CLINIC CLARENDON
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jul 22, 1996
- Last certification
- Dec 16, 2019
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Sep 1, 2008 in AR
- Enrollment address
- 198 South Main Street
Baptist Health - Family Clinic Clar
Clarendon, AR 72029-2756 - Related CCNs
- 040072
All disclosed owners & managing parties 21
| Name | Role | Since | Share |
|---|---|---|---|
| Larry White |
Corporate Director | Jan 1, 2026 | |
| Baptist Health |
Operational/Managerial Control | Jan 1, 2009 | |
| Ronald Dedman |
Corporate Director | Jan 1, 2026 | |
| Lamarr Bailey |
Corporate Director | Jan 1, 2026 | |
| Herren Hickingbotham |
Corporate Director | Jan 1, 2026 | |
| Judy Simmons Henry |
Corporate Director | Jan 1, 2026 | |
| Michael Akin |
Corporate Director | Jan 1, 2026 | |
| Chris Brune |
Corporate Director | Jan 1, 2026 | |
| Troy Wells |
Corporate Director | Jan 1, 2009 | |
| W-2 Managing Employee | Jul 1, 2014 | ||
| Suzanne Peyton |
Corporate Director | Jan 1, 2026 | |
| John McMorran |
Corporate Director | Jan 1, 2026 | |
| Steven D Weeks |
Corporate Director | Jan 1, 2009 | |
| Lindsey Lorence |
Corporate Director | Jan 1, 2026 | |
| Steven Booth |
Corporate Director | Jan 1, 2026 | |
| David Mitchell |
Corporate Director | Jan 1, 2026 | |
| James S Jones |
Corporate Director | Jan 1, 2026 | |
| Louis M Lee |
Corporate Director | Jan 1, 2026 | |
| Teresa Howell |
Corporate Director | Jan 1, 2026 | |
| Brent Beaulieu |
Corporate Officer | Jan 18, 2018 | |
| W-2 Managing Employee | Jan 18, 2018 | ||
| Glenn Millner |
Corporate Director | Jan 1, 2026 | |
| Les Warren |
Corporate Director | Jan 1, 2026 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091117000588 | AR | Part a Provider - Rural Health Clinic | 3870659246 | Practice locations: Clarendon, AR |
National Provider Directory
- Tax ID family
- Baptist Health Hospitals
- Part of
- Baptist Health Hospitals
Locations
198 N Main St
Clarendon, AR 72029
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | AR | Yes |
Addresses
Primary practice location
198 South Main Street
Clarendon, AR 72029-2756
Mailing address
11001 Executive Center Drive
Suite 200
Little Rock, AR 72211-4393
Phone (501) 812-7800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 129735729 | Medicaid | AR | |
| 201479729 | Medicaid | AR |
Other names
- Baptist Health Family Clinic Clarendon
Other providers in Clarendon, AR
- Earnestine Annette Artis
- Clarendon Pharmacy Inc
- Clarendon Public Schools
- Dewitt Hospital & Nursing Home, Inc
- Christina Kaye Dunlap
- Megan Ellis
All providers in Clarendon, AR · Rural Health 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 Apr 2, 2025. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- 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.