NPIMap

Organization Active NPI

Baxter County Regional Hospital Inc

Doing business as D/B/a BRMC Ash Flat Clinic

  • Family Medicine Physician
  • Ash Flat, AR
National Provider Identifier
1699945147
Registry record updated Aug 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
AR3827 Issued in AR
Legal business name
BAXTER COUNTY REGIONAL HOSPITAL INC
Doing business as
D/B/a BRMC Ash Flat Clinic
Practice address
970 Ash Flat Dr
Ash Flat, AR 72513-0790
Phone
(870) 994-7301
Fax
(870) 994-7488
NPI assigned
Mar 11, 2008
Last updated
Aug 2, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 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
Family Medicine Physician 207Q00000X AR3827 AR Primary

Addresses

Primary practice location

970 Ash Flat Dr
Ash Flat, AR 72513-0790

Mailing address

970 Ash Flat Dr
Ash Flat, AR 72513-0790
Phone (870) 994-7301

Other identifiers 1

IdentifierTypeStateIssuer
168205002MedicaidAR

Other names 1

  • D/B/A BRMC ASH FLAT CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080514000435 AR Part B Supplier - Clinic/Group Practice 0042389264 Receives reassigned benefits from 16 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mountain Home, AR; Harrison, AR

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501632000000",
    "number": "1699945147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 ASH FLAT DR",
            "city": "ASH FLAT",
            "state": "AR",
            "postal_code": "725130790",
            "telephone_number": "870-994-7301",
            "fax_number": "870-994-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 ASH FLAT DR",
            "city": "ASH FLAT",
            "state": "AR",
            "postal_code": "725130790",
            "telephone_number": "870-994-7301",
            "fax_number": "870-994-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAXTER COUNTY REGIONAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2017-08-02",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "AR3827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168205002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "D/B/A BRMC ASH FLAT CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ash Flat, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.