NPIMap

Organization Active NPI

Baxter County Regional Hospital, Inc

Doing business as Baxter Regional Vitality Clinic

  • Adult Medicine Physician
  • Mountain Home, AR
National Provider Identifier
1790257673
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
BAXTER COUNTY REGIONAL HOSPITAL, INC
Doing business as
Baxter Regional Vitality Clinic
Practice address
310 Buttercup Dr Ste C
Mountain Home, AR 72653-2932
Phone
(870) 508-6976
Fax
(870) 508-1615
NPI assigned
Dec 17, 2018
Last updated
Dec 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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
Adult Medicine Physician 207QA0505X NU Primary

Addresses

Primary practice location

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

Mailing address

310 Buttercup Dr Ste C
Mountain Home, AR 72653-2932
Phone (870) 508-6976

Other names 1

  • Baxter Regional Vitality Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Baxter County Reg Hosp Inc40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545004800000",
    "number": "1790257673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 BUTTERCUP DR STE C",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532932",
            "telephone_number": "870-508-6976",
            "fax_number": "870-508-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 BUTTERCUP DR STE C",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532932",
            "telephone_number": "870-508-6976",
            "fax_number": "870-508-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAXTER COUNTY REGIONAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "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": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baxter Regional Vitality 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 Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.