White River Health System, Inc
Organization Active NPI Anesthesiology Physician · Batesville, AR
NPI 1760410229 · NPPES record last updated May 2, 2024
Key facts
- NPI
- 1760410229
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- WHITE RIVER HEALTH SYSTEM, INC
- Practice address
- 1710 Harrison St
Batesville, AR 72501-7303 - Phone
- (870) 262-1200
- Fax
- (870) 262-3284
- NPI assigned
- Jun 30, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- WHITE RIVER HEALTH SYSTEM, INC
Authorized official
- Name
- Shawna Baxter
- Title
- Provider Enrollment
- Phone
- (870) 262-5545
Other NPIs on the same Medicare enrollment 16
Corporate family (same tax ID) 47
Member organizations 3
Related certifications (CCN) 13
Practitioners 32
-
James Davis Allen, M.D.
-
John William Allgood Jr., M.D.
-
Jeffery Deoin Angel, M.D.
-
Erica Caraway, APRN
-
Dylan Price Carpenter, M.D.
-
Donna Dutton, CNP
-
Luke Edgecombe, M.D.
-
Brandee M Fowler, MS, RD, LD
-
Chad Lee Grady, APRN
-
Atif Khan, MD
-
John Sydney Lambert, M.D.
-
Joshua McIntosh, APRN
-
Savannah Rolins, FNP-C
-
Michelle Ann Snow, APRN
-
Seth Stone, APRN
-
Charlett Watson, NP
-
Stephen Ko, MD
-
Benjamin M Dodge, M.D.
Affiliated clinicians 353
-
Dana C Abraham, M.D.
-
Tarek Abuelem, M.D.
-
Ahmed Salah Ahmed, M.D.
-
Ragda Ahmed, MD
-
John Akins, MD
-
Daisy V Alapat, MD
-
Audrey Rachel Alexander, APRN
-
Mohammed Alhajji, M.D
-
Crystal Allen, APRN
-
Jana Allen, CRNA
-
Julia L Allen, MD
-
John William Allgood Jr., M.D.
-
Amanda Michelle Anderson, APRN, FNP-C
-
Brandy N Anderson, APRN
-
Elizabeth Divina Anderson, CRNA, DNP
-
Caitlin Anne Andryka, PA-C
-
Jeffery Deoin Angel, M.D.
-
Griffin A Arnold II, M.D.
Medicare Care Compare: Hospital
- Listed as
- White River Medical Center
- Overall star rating
- ★★★☆☆ 3 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AR
Hospital certification: CCN 040119
- Legal name
- WHITE RIVER HEALTH SYSTEM, INC.
- Doing business as
- WHITE RIVER MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jan 30, 1976
- Last certification
- Apr 6, 2023
- Beds
- 224
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 31, 1976 in AR
- Enrollment address
- 1710 Harrison St
White River Medical Center
Batesville, AR 72501-7303 - Hospital subgroups
- Acute care
All disclosed owners & managing parties 18
| Name | Role | Since | Share |
|---|---|---|---|
| Crystal Johnson |
Corporate Director |
Jan 1, 2025 | |
| White River Health System, Inc. |
5% Or Greater Direct Ownership Interest | Jan 31, 1976 | |
| Operational/Managerial Control | Jan 31, 1976 | ||
| Steve Case |
Corporate Director |
Jan 1, 2025 | |
| Stacy Gunderman |
Corporate Director |
Jan 1, 2025 | |
| Maggie Williams |
Corporate Director |
Jan 1, 2025 | |
| Danny Bell |
Corporate Director |
Jan 1, 2025 | |
| Robert McIntire |
Corporate Director |
Jan 1, 2025 | |
| Elizabeth Christian |
Corporate Director |
Jan 1, 2025 | |
| Jason Taylor |
Corporate Director |
Jan 1, 2025 | |
| Tina Wheelis |
Corporate Director |
Jan 1, 2025 | |
| Jeff Showalter |
Corporate Director |
Jan 1, 2025 | |
| Shawna Baxter |
W-2 Managing Employee |
Aug 28, 2023 | |
| Kevin S Rose |
Corporate Director |
Jan 1, 2025 | |
| Randy Cross |
Corporate Director |
Jan 1, 2025 | |
| Kathy Lanier |
Corporate Director |
Jan 1, 2025 | |
| Lisa Lambert |
Corporate Director |
Jan 1, 2024 | |
| William Tyler Fowlkes |
Corporate Director |
Jan 1, 2025 | |
| Lance Lamberth |
Corporate Director |
Jan 1, 2025 |
All facility ownership & control disclosures 17
| Facility | Type | Role | Since |
|---|---|---|---|
| White River Medical Center |
Hospital | 5% Or Greater Direct Ownership Interest Operational/Managerial Control |
Jan 31, 1976 Jan 31, 1976 |
| Stone County Medical Center |
Hospital | Operational/Managerial Control | Jan 1, 2008 |
| Stone County Medical Center |
Hospital | 5% Or Greater Direct Ownership Interest | Apr 1, 1999 |
| White River Medical Center |
Hospital | Operational/Managerial Control | Dec 21, 2007 |
| White River Medical Center Rehabilitation Unit |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 1976 |
| Midway Medical Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Sep 10, 2010 |
| Melbourne Medical Clinic |
Rural health clinic | Operational/Managerial Control | Oct 16, 2007 |
| Drasco Medical Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest | Jul 12, 1996 |
| Cave City Medical Clinic |
Rural health clinic | Operational/Managerial Control | Nov 19, 1991 |
| Plesant Plains Medical Clinic |
Rural health clinic | Operational/Managerial Control | Jul 1, 2006 |
| White River Health Family Care |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Aug 1, 2015 |
| Sugarloaf Medical Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Feb 1, 2021 |
| White River Health Family Care |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Feb 1, 2023 |
| White River Health Family Care |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Feb 1, 2023 |
| White River Health Family Care |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Feb 1, 2023 |
| White River Health Care Family |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jun 1, 2023 |
| White River Health Children'S Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jun 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031203000615 | AR | Part B Supplier - Clinic/Group Practice | 0143134270 |
Receives reassigned benefits from 24 practitioners 2 other NPIs on this enrollment Practice locations: Mountain View, AR; Newport, AR; Melbourne, AR; Heber Springs, AR; Cherokee Village, AR; Batesville, AR |
| O20040216000496 | AR | Part a Provider - Hospital | 0143134270 |
16 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Batesville, AR; Mountain View, AR; Cherokee Village, AR |
National Provider Directory
- Tax ID family
- White Riv HLTH Syst Inc
- Part of
- White Riv HLTH Syst Inc
Locations
1215 Sidney St
Ste 203
Batesville, AR 72501
1700 Harrison St
Ste S
Batesville, AR 72501
Phone (870) 698-9900
525 Virginia Dr
Ste A
Batesville, AR 72501
224 E Matthews Ave
Jonesboro, AR 72401
Phone (501) 972-4172
19797 Highway 5
Mountain View, AR 72560
Phone (870) 269-4144
2106 E Main St
Mountain View, AR 72560
Phone (870) 262-5056
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes | ||
| Pain Medicine (Anesthesiology) Physician |
207LP2900X | |||
| Emergency Medicine Physician |
207P00000X | |||
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | |||
| Hospitalist Physician |
208M00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
1710 Harrison St
Batesville, AR 72501-7303
Mailing address
1710 Harrison St
Batesville, AR 72501-7303
Phone (870) 262-1200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102781002 | Medicaid | AR |
Other names
- White River Med Physicians
Other providers in Batesville, AR
- White River Health System Inc
- White River Health System, Inc
- White River Health System, Inc
- White River Health System, Inc
- White River Health System, Inc
- White River Health System, Inc
- White River Health System, Inc
- White River Health System, Inc.
- White River Health System, Inc.
- White River Health System, Inc.
All providers in Batesville, AR · Anesthesiology Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2024. 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.