NPIMap

Organization Active NPI

Baxter County Regional Hospital, Inc

Doing business as Baxter Health Bone & Joint Clinic

  • Surgery Physician
  • Mountain Home, AR
National Provider Identifier
1639472830
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
BAXTER COUNTY REGIONAL HOSPITAL, INC
Doing business as
Baxter Health Bone & Joint Clinic
Practice address
639 Broadmoor Cir
Mountain Home, AR 72653-2901
Phone
(870) 424-4710
Fax
(870) 424-4780
NPI assigned
Dec 9, 2010
Last updated
Feb 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

639 Broadmoor Cir
Mountain Home, AR 72653-2901

Mailing address

639 Broadmoor Cir
Mountain Home, AR 72653-2901
Phone (870) 424-4710

Other names 1

  • Baxter Health Bone & Joint Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MO3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20110222000232 AR Part B Supplier - Clinic/Group Practice 0042389264 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: Melbourne, AR; Salem, AR; Mountain View, AR; Mountain Home, AR; Hihgland, AR
O20130920000780 AR DME Supplier - Physician - Unknown Physician Specialty 0042389264 Practice locations: Mountain Home, AR
O20200510000002 MO Part B Supplier - Clinic/Group Practice 0042389264 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Plains, MO

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Member of 1

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

Locations

2178 Highway 62 412
Ste A
Highland, AR 72542
Phone (870) 424-4710

103 Mountain Place Dr
Mountain View, AR 72560
Phone (870) 269-3447

103 Mountain Place Dr
Ste D
Mountain View, AR 72560
Phone (870) 424-4710

Practitioners & affiliated clinicians

Practitioners 8

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": "1291852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1639472830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 BROADMOOR CIR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532901",
            "telephone_number": "870-424-4710",
            "fax_number": "870-424-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 BROADMOOR CIR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532901",
            "telephone_number": "870-424-4710",
            "fax_number": "870-424-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAXTER COUNTY REGIONAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-09",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "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": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baxter Health Bone & Joint 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 Feb 24, 2023; 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.