NPIMap

Organization Active NPI

Baxter County Regional Hospital, Inc.

Doing business as Baxter Regional Nephrology & Pulmonology Clinic

  • Pulmonary Disease Physician
  • Mountain Home, AR
National Provider Identifier
1629405113
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
BAXTER COUNTY REGIONAL HOSPITAL, INC.
Doing business as
Baxter Regional Nephrology & Pulmonology Clinic
Practice address
555 W 6TH St
Mountain Home, AR 72653-3409
Phone
(870) 425-1787
Fax
(870) 425-2009
NPI assigned
Sep 30, 2013
Last updated
Oct 10, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
BAXTER COUNTY REGIONAL HOSPITAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Authorized official

Name
Debra Henry
Title
Cfo
Phone
(870) 508-1003

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU
Pulmonary Disease Physician 207RP1001X NU Primary

Addresses

Primary practice location

555 W 6TH St
Mountain Home, AR 72653-3409

Mailing address

555 W 6TH St
Mountain Home, AR 72653-3409
Phone (870) 425-1787

Other names 1

  • Baxter Regional Nephrology & Pulmonology Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120326000509 AR Part B Supplier - Clinic/Group Practice 0042389264 Receives reassigned benefits from 9 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mountain Home, AR

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Part of
Baxter County Reg Hosp Inc

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570665600000",
    "number": "1629405113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W 6TH ST",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533409",
            "telephone_number": "870-425-1787",
            "fax_number": "870-425-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W 6TH ST",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533409",
            "telephone_number": "870-425-1787",
            "fax_number": "870-425-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAXTER COUNTY REGIONAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAXTER COUNTY REGIONAL HOSPITAL, INC",
        "enumeration_date": "2013-09-30",
        "last_updated": "2019-10-10",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "870-508-1003"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baxter Regional Nephrology & Pulmonology Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mountain Home, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.