White Mountain Regional Medical Center
Organization Active NPI Critical Access Hospital · Springerville, AZ
NPI 1699766592 · NPPES record last updated Nov 22, 2023
Key facts
- NPI
- 1699766592
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- H2530 (AZ)
- Legal business name
- WHITE MOUNTAIN REGIONAL MEDICAL CENTER
- Practice address
- 118 S Mountain Ave
Springerville, AZ 85938-5104 - Phone
- (928) 333-4368
- Fax
- (928) 333-4369
- NPI assigned
- Oct 31, 2005
- Organization subpart
- No
Authorized official
- Name
- Wesley Babers
- Title
- Ceo
- Phone
- (928) 333-7178
Owners & managing parties with NPI records 1
-
Steven Matthew Hopkins, D.O.
Subparts reporting this organization as parent 2
Practitioners 25
-
Grant S Berges, MD
-
Thomas Chambers, D.P.M.
-
Glenn Micah Finch, MSN, RN, FNP
-
Ramsey Finch, NP
-
Ashley Kelepolo, NP
-
Chad Allen Squire, DPM
-
Steven Matthew Hopkins, D.O.
-
Hal Richins Jr., MD
-
Don A Shumway, DPM
-
Pamela S Lowry, FNP-BC
-
Angela Walther, LCSW
-
Joseph Eich, PA-C
-
Reece Kirby Hadlock, PA-C
-
Michelle Lynn Page, FNP
-
Jasmine Summers, PMHNP
-
Ryan Dan Bingham, FPMHNP
-
Susanna Tran, MD
Affiliated clinicians 55
-
Mark Bailey, MD
-
Grant S Berges, MD
-
Curtis Vance Birdno, PA-C
-
Craig Gilbert Brady, D.O.
-
Ian Kay Brimhall, DO
-
Lynn Bryan, MD
-
Thomas Chambers, D.P.M.
-
Benjamin Paul Coleman, D.O.
-
Geoffrey Dee Cornelsen, D.O.
-
Ralph A. D'Silva, M.D.
-
Burke Delange, D.O.
-
Glenn Micah Finch, MSN, RN, FNP
-
Ramsey Finch, NP
-
Linda Marie Fischer, FNP-C
-
Reece Kirby Hadlock, PA-C
-
Larry Travis Heap, PA-C
-
Warren Reyes Ho, MD
-
Ashley Kelepolo, NP
Medicare Care Compare: Hospital
- Listed as
- White Mountain Regional Medical Center
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in AZ
Hospital certification: CCN 031315
- Legal name
- WHITE MOUNTAIN REGIONAL MEDICAL CENTER
- Doing business as
- WHITE MOUNTAIN REGIONAL MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Aug 26, 2008
- Last certification
- Jul 24, 2024
- Beds
- 25
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Nov 27, 1959 in AZ
- Enrollment address
- 118 S Mountain Ave
Springerville, AZ 85938-5104
Hospital certification: CCN 03Z315
- Legal name
- WHITE MOUNTAIN REGIONAL MEDICAL CENTER
- Doing business as
- WHITE MOUNTAIN REGIONAL MEDICAL CENTER
- Organization structure
- Other · Non-profit
- Incorporated
- Nov 27, 1959 in AZ
- Enrollment address
- 118 S Mountain Ave
Springerville, AZ 85938-5104
Rural health clinic certification: CCN 038509
- Legal name
- WHITE MOUNTAIN REGIONAL MEDICAL CENTER
- Doing business as
- WHITE MOUNTAIN REGIONAL MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jul 13, 2018
- Last certification
- Jan 4, 2021
- Ownership / control type
- 2B
- Organization structure
- Other · Non-profit
- Incorporated
- Nov 3, 1959 in AZ
- Enrollment address
- 606 N Main St
Eagar, AZ 85925-9813 - Related CCNs
- 031315
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Steven M Hopkins |
Corporate Officer |
Dec 1, 2022 | |
| Corporate Officer |
Jan 1, 2022 | ||
| Wesley Babers |
Corporate Director |
Sep 1, 2023 | |
| W-2 Managing Employee |
Sep 1, 2023 | ||
| 5% Or Greater Indirect Ownership Interest | Sep 1, 2023 | ||
| Corporate Officer |
Sep 1, 2023 | ||
| 5% Or Greater Indirect Ownership Interest | Dec 1, 2022 | ||
| Corporate Officer |
Dec 1, 2022 | ||
| W-2 Managing Employee |
Dec 1, 2022 | ||
| Operational/Managerial Control | Dec 1, 2022 | ||
| Ashley Jaramillo |
Corporate Officer |
Sep 1, 2023 | |
| Corporate Officer |
Dec 1, 2022 | ||
| W-2 Managing Employee | Dec 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040123000416 | AZ | Part B Supplier - Clinic/Group Practice | 1951203512 |
Receives reassigned benefits from 18 practitioners Practice locations: Springerville, AZ |
| O20080923000361 | AZ | Part a Provider - Critical Access Hospital | 1951203512 |
Receives reassigned benefits from 7 practitioners Practice locations: Springerville, AZ |
| O20080923000495 | AZ | Part a Provider - Critical Access Hospital | 1951203512 | Practice locations: Springerville, AZ |
| O20180221003017 | AZ | Part a Provider - Rural Health Clinic | 1951203512 | Practice locations: Eagar, AZ |
National Provider Directory
Locations
120 S Mountain Ave
Springerville, AZ 85938
Interoperability endpoints
- ehr-direct@wmrmc.hin.us
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | H2530 | AZ | Yes |
Addresses
Primary practice location
118 S Mountain Ave
Springerville, AZ 85938-5104
Mailing address
118 S Mountain Ave
Springerville, AZ 85938-5104
Phone (928) 333-4368
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 192584 | Medicaid | AZ |
Other names
- White Mountain Commu
Other providers in Springerville, AZ
- Valley Spring Behavioral Health LLC
- Western Drug Inc
- White Mountain Ambulance Service, Inc.
- White Mountain Pain Clinic, PLLC
- White Mountain Regional Medical Center
- Kathleen Whitmore
All providers in Springerville, AZ · Critical Access Hospital in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.