NPIMap

Organization Active NPI

Baxter County Regional Hospital, Inc

Doing business as Interventional Pain Management

  • Pain Clinic/Center
  • Harrison, AR
National Provider Identifier
1720430309
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
BAXTER COUNTY REGIONAL HOSPITAL, INC
Doing business as
Interventional Pain Management
Practice address
114 E Crandall Ave Ste a
Harrison, AR 72601-3628
Phone
(870) 365-0130
Fax
(870) 565-0131
NPI assigned
Jul 7, 2016
Last updated
Aug 15, 2025By 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 Aug 15, 2025

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
Pain Clinic/Center 261QP3300X AR Primary

Addresses

Primary practice location

114 E Crandall Ave Ste a
Harrison, AR 72601-3628

Mailing address

114 E Crandall Ave Ste a
Harrison, AR 72601-3628
Phone (870) 365-0130

Other names 1

  • Interventional Pain Management Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20161201002096 AR Part B Supplier - Clinic/Group Practice 0042389264 Receives reassigned benefits from 15 practitioners
Practice locations: Harrison, AR
O20210520001652 MO Part B Supplier - Clinic/Group Practice 0042389264 Receives reassigned benefits from 2 practitioners
Practice locations: West Plains, MO

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2115414Interventional Pain Management Associates114 E Crandall Suite a, Harrison, AR 72601Certificate of waiverJul 6, 2028

National Provider Directory

National Provider Directory
Part of
Baxter Cnty Reg Hosp Inc

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1720430309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E CRANDALL AVE STE A",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726013628",
            "telephone_number": "870-365-0130",
            "fax_number": "870-565-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E CRANDALL AVE STE A",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726013628",
            "telephone_number": "870-365-0130",
            "fax_number": "870-565-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAXTER COUNTY REGIONAL HOSPITAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAXTER COUNTY REGIONAL HOSPITAL, INC",
        "enumeration_date": "2016-07-07",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "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": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Interventional Pain Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrison, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.