NPIMap

Organization Active NPI

Baxter County Regional Hospital Inc

Doing business as Baxter Health Neurosurgery & Spine Clinic

  • Neurological Surgery Physician
  • Mountain Home, AR
National Provider Identifier
1720515737
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
BAXTER COUNTY REGIONAL HOSPITAL INC
Doing business as
Baxter Health Neurosurgery & Spine Clinic
Practice address
310 Buttercup Dr Ste a
Mountain Home, AR 72653-2932
Phone
(870) 508-7080
Fax
(870) 508-7865
NPI assigned
May 22, 2017
Last updated
Sep 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

310 Buttercup Dr Ste a
Mountain Home, AR 72653-2932

Mailing address

310 Buttercup Dr Ste a
Mountain Home, AR 72653-2932
Phone (870) 508-7080

Other practice location 1

306 N Chestnut St
Harrison, AR 72601-4453
Phone (870) 508-7080

Other names 1

  • Baxter Health Neurosurgery & Spine Clinic 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
O20080514000689 AR Part B Supplier - Clinic/Group Practice 0042389264 Receives reassigned benefits from 10 practitioners
2 other NPIs on this enrollment
Practice locations: Ash Flat, AR; Hardy, AR; Harrison, AR; Melbourne, AR; Mountain Home, AR; Mountain View, AR; Yellville, AR
O20200510000002 MO Part B Supplier - Clinic/Group Practice 0042389264 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
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).

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Baxter Co Reg Hospital Inc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

49 Highway 62 412
#C
Ash Flat, AR 72513

1420 Highway 62 65 N
Ste 4
Harrison, AR 72601
Phone (870) 508-7080

1402 N Kentucky Ave
Ste C
West Plains, MO 65775

Practitioners & affiliated clinicians

Practitioners 51

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 51

NPI Registry JSON

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1720515737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 BUTTERCUP DR STE A",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532932",
            "telephone_number": "870-508-7080",
            "fax_number": "870-508-7865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 BUTTERCUP DR STE A",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532932",
            "telephone_number": "870-508-7080",
            "fax_number": "870-508-7865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 N Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Harrison",
            "state": "AR",
            "postal_code": "726014453",
            "country_code": "US",
            "telephone_number": "870-508-7080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BAXTER COUNTY REGIONAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-22",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "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": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baxter Health Neurosurgery & Spine 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 Sep 20, 2022; 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.