NPIMap

Organization Active NPI

Sevier County Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • De Queen, AR
National Provider Identifier
1750099800
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
SEVIER COUNTY MEDICAL CENTER
Practice address
960 Hwy 71 N
De Queen, AR 71832-9415
Phone
(870) 642-6420
Fax
(870) 584-1670
NPI assigned
Nov 8, 2022
Last updated
Nov 8, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
SEVIER COUNTY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Authorized official

Name
Lori L House
Title
President & Ceo
Phone
(870) 584-1601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X NU Primary

Addresses

Primary practice location

960 Hwy 71 N
De Queen, AR 71832-9415

Mailing address

PO Box 960
De Queen, AR 71832-0960
Phone (870) 642-6420

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Workstation Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231111000383 AR Part A Provider - Critical Access Hospital 5890166722 Receives reassigned benefits from 16 practitioners
Practice locations: De Queen, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750099800. Details of each certification follow.

Hospital certification: CCN 04Z333

Legal name
SEVIER COUNTY MEDICAL CENTER
Organization structure
GovernmentNon-profit
Enrollment address
960 Highway 71 N
De Queen, AR 71832-9415
Hospital Swing-Bed Unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Sevier County Medical Center2 organizations share this tax ID, including this one
Part of
Sevier County Medical Center

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Candice McDonnell Individual W-2 Managing Employee Jan 23, 2022
Stacy Dowdy Individual W-2 Managing EmployeeChief Executive Officer Oct 4, 2021 100%
Sheri Dinkins Individual W-2 Managing EmployeeBilling Supervisor Oct 31, 2022
Steve L Cole Individual Corporate DirectorMember of the Board of Governors Nov 4, 2019 14.3%

Practitioners & affiliated clinicians

Practitioners 26

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 26

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1750099800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 960",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718320960",
            "telephone_number": "870-642-6420",
            "fax_number": "870-584-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 HWY 71 N",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718329415",
            "telephone_number": "870-642-6420",
            "fax_number": "870-584-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEVIER COUNTY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEVIER COUNTY MEDICAL CENTER",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-04",
        "status": "A",
        "authorized_official_last_name": "HOUSE",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "870-584-1601"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Workstation",
            "affiliation": "N",
            "endpointDescription": "PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "960 Hwy 71 N",
            "city": "De Queen",
            "state": "AR",
            "country_code": "US",
            "postal_code": "718329415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in De Queen, AR

Sources for this page

Verify at the official NPI Registry.