CHI St. Vincent Medical Group Hot Springs
Organization Active NPI Rural Health Clinic/Center · Murfreesboro, AR
NPI 1598095325 · NPPES record last updated Mar 2, 2020
Key facts
- NPI
- 1598095325
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- CHI ST. VINCENT MEDICAL GROUP HOT SPRINGS
- Practice address
- 319 E 13TH St
Murfreesboro, AR 71958-9541 - Phone
- (870) 285-3118
- Fax
- (870) 285-2759
- NPI assigned
- Dec 29, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Shawn Barnett
- Title
- Cfo
- Phone
- (501) 609-2229
Owners & managing parties with NPI records 12
-
Seth M Barnes, MD
-
Lawrence D Dodd, M.D.
-
Seth A Hollenbach, M.D.
-
Ashley Thurston Jenkins, M.D.
-
Patrick Richard Kennedy, M.D.
Other NPIs with the same Medicare PAC ID 3
Member of 1
Facilities with the same owner 4
Practitioners 184
-
Darrell W Elkin, PA
-
John N Howell, PA
-
Oyidie Igbokidi, MD
-
Mark Eugene Larey, D.O.
-
Natalie E Summitt, APRN
-
Mary Darlene Abernathy, A. P. N.
-
Yuba Raj Acharya, M.D.
-
Halah Al-Dadah, M.D.
-
Rawan T Al-Odat, M.D
-
Edward E Angtuaco, M.D.
-
Arinze Anyabolu, MBBS
-
Ragan D Arrison, NP
-
James Michael Arthur, M.D.
-
Jodi M Barboza, MD
-
Seth M Barnes, MD
-
Susan Clare Beaty, AU.D.
-
Amy M Bennett, APN
-
Junu Bhattarai, MD
-
Laryssa Lauret Blunt, APRN
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D0938641 | CHI St Vincent Medical Group Hot Springs | Compliance | Jun 5, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AR
Rural health clinic certification: CCN 043869
- Legal name
- CHI ST VINCENT MEDICAL GROUP HOT SPRINGS
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jul 8, 2010
- Last certification
- Jan 30, 2017
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 1, 2008 in AR
- Enrollment address
- 319 E 13TH Street
Mercy Clinic Hot Springs Communities
Murfreesboro, AR 71958-9541
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| CHI St Vincent Hot Springs |
5% Or Greater Indirect Ownership Interest | Jul 8, 2010 | 100% |
| Commonspirit Health |
5% Or Greater Indirect Ownership Interest | Apr 1, 2014 | 100% |
| Patricia M Jones |
W-2 Managing Employee |
Apr 1, 2014 | |
| Michael Bodemann |
Corporate Director |
Mar 1, 2008 | 9% |
| Seth a Hollenbach |
Corporate Director |
Jul 1, 2018 | |
| Ashley T Jenkins |
Corporate Director |
May 14, 2021 | |
| Thomas H Hollis |
Corporate Director |
Oct 1, 2013 | 9% |
| Lawrence Dodd |
Corporate Director |
Jul 1, 2018 | |
| Jeffrey Miller |
Corporate Director |
Jul 1, 2018 | |
| Amy Gordon |
Corporate Director | May 14, 2021 | |
| St Vincent Infirmary Medical Center |
5% Or Greater Indirect Ownership Interest | Apr 1, 2014 | 100% |
| Seth M Barnes |
Corporate Director |
May 14, 2021 | |
| Patrick Kennedy |
Corporate Director |
Jul 1, 2018 | |
| Zachary S Larrimer |
Corporate Director |
May 14, 2021 | |
| Shawn Barnett |
Corporate Director |
Mar 19, 2018 | |
| W-2 Managing Employee |
Mar 19, 2018 | ||
| Theresa Polk |
W-2 Managing Employee |
Apr 1, 2014 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100301000899 | AR | Part a Provider - Rural Health Clinic | 3971673716 | Practice locations: Murfreesboro, AR |
| O20100918000086 | AR | Part B Supplier - Clinic/Group Practice | 3971673716 |
Receives reassigned benefits from 6 practitioners Practice locations: Murfreesboro, AR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
319 E 13TH St
Murfreesboro, AR 71958-9541
Mailing address
PO Box 21850
Hot Springs, AR 71903-1850
Phone (501) 627-1800
Other providers in Murfreesboro, AR
- Audra Rhodes DDS PA
- Patricia Baldwin
- Janice Ann Beene
- Lindsey K Brown
- Patricia Ann Chaloner
- Leslie Daniels
- Darwin Turner, D.D.S., Inc.
- Bradley Deal
- Maria Figueroa-Gonzalez
- Rachel Flurry
All providers in Murfreesboro, 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 Mar 2, 2020. 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.