NPIMap

Organization Active NPI

Baxter County Regional Hospital

Doing business as Baxter Regional Urology Clinic

  • Urology Physician
  • Mountain Home, AR
National Provider Identifier
1659400257
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
AR3827 Issued in AR
Legal business name
BAXTER COUNTY REGIONAL HOSPITAL
Doing business as
Baxter Regional Urology Clinic
Practice address
628 Hospital Dr Ste 3a
Mountain Home, AR 72653-2952
Phone
(870) 508-6020
Fax
(870) 508-6025
NPI assigned
Mar 2, 2007
Last updated
Mar 9, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 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
Urology Physician 208800000X AR3827 AR Primary

Addresses

Primary practice location

628 Hospital Dr Ste 3a
Mountain Home, AR 72653-2952

Mailing address

628 Hospital Dr Ste 3a
Mountain Home, AR 72653-2952
Phone (870) 508-6020

Other identifiers 1

IdentifierTypeStateIssuer
101068002MedicaidAR

Other names 1

  • Baxter Regional Urology Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Baxter Cnty Reg Hosp Inc44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489017600000",
    "number": "1659400257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 HOSPITAL DR STE 3A",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532952",
            "telephone_number": "870-508-6020",
            "fax_number": "870-508-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 HOSPITAL DR STE 3A",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532952",
            "telephone_number": "870-508-6020",
            "fax_number": "870-508-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAXTER COUNTY REGIONAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2017-03-09",
        "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": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AR",
            "license": "AR3827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101068002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baxter Regional Urology 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 Mar 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.