NPIMap

Organization Active NPI

BRMC Clinic at Salem, Arkansas

  • Primary Care Clinic/Center
  • Salem, AR
National Provider Identifier
1649522897
Registry record updated Jul 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
BRMC CLINIC AT SALEM, ARKANSAS
Practice address
106 Highway 62 W
Salem, AR 72576-8059
Phone
(870) 895-2762
Fax
(870) 895-4025
NPI assigned
Oct 12, 2012
Last updated
Jul 20, 2017By 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 Jul 20, 2017

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
Primary Care Clinic/Center 261QP2300X AR Primary

Addresses

Primary practice location

106 Highway 62 W
Salem, AR 72576-8059

Mailing address

PO Box 309
Salem, AR 72576-0309
Phone (870) 895-2762

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

NPI Registry JSON

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500508800000",
    "number": "1649522897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 309",
            "city": "SALEM",
            "state": "AR",
            "postal_code": "725760309",
            "telephone_number": "870-895-2762",
            "fax_number": "870-895-4025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 HIGHWAY 62 W",
            "city": "SALEM",
            "state": "AR",
            "postal_code": "725768059",
            "telephone_number": "870-895-2762",
            "fax_number": "870-895-4025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRMC CLINIC AT SALEM, ARKANSAS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAXTER COUNTY REGIONAL HOSPITAL, INC",
        "enumeration_date": "2012-10-12",
        "last_updated": "2017-07-20",
        "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": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2017; 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.