NPIMap

Organization Active NPI

St Bernards Community Hospital Corp

Doing business as Crossridge Community Hospital

  • Critical Access Hospital
  • Wynne, AR
National Provider Identifier
1689898140
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
AR4063 Issued in AR
Legal business name
ST BERNARDS COMMUNITY HOSPITAL CORP
Doing business as
Crossridge Community Hospital
Practice address
310 Falls Blvd S
Wynne, AR 72396-3013
Phone
(870) 238-3300
Fax
(870) 238-7432
NPI assigned
Apr 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Authorized official

Name
Bryan Mattes
Title
Associate Administrator
Phone
(870) 238-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X AR4063 AR Primary

Addresses

Primary practice location

310 Falls Blvd S
Wynne, AR 72396-3013

Mailing address

310 Falls Blvd S
Wynne, AR 72396-3013
Phone (870) 238-3300

Other identifiers 2

IdentifierTypeStateIssuer
57861OtherARBLUE CROSS CRNA
120461702MedicaidAR

Other names 1

  • Crossridge Community Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Cross.Ridge@cr.hin.us Direct

National Provider Directory

National Provider Directory
Tax ID family
Crossridge Community Ho5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600300800000",
    "number": "1689898140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 FALLS BLVD S",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963013",
            "telephone_number": "870-238-3300",
            "fax_number": "870-238-7432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 FALLS BLVD S",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963013",
            "telephone_number": "870-238-3300",
            "fax_number": "870-238-7432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST BERNARDS COMMUNITY HOSPITAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A",
        "authorized_official_last_name": "MATTES",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "ASSOCIATE ADMINISTRATOR",
        "authorized_official_telephone_number": "870-238-3300"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "AR",
            "license": "AR4063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS CRNA",
            "identifier": "57861",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120461702",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Cross.Ridge@cr.hin.us",
            "affiliation": "N",
            "endpointDescription": "direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct email address",
            "address_1": "310 Falls Blvd S",
            "city": "Wynne",
            "state": "AR",
            "country_code": "US",
            "postal_code": "723963013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Crossridge Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crossridge Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wynne, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.