NPIMap

Organization Active NPI

Healthstar Physicians of Hot Springs, PLLC

Doing business as Hamilton West Family Medicine

  • Family Medicine Physician
  • Hot Springs, AR
National Provider Identifier
1821176934
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HEALTHSTAR PHYSICIANS OF HOT SPRINGS, PLLC
Doing business as
Hamilton West Family Medicine
Practice address
1629 Airport Rd
Suite B
Hot Springs, AR 71913-7951
Phone
(501) 767-0075
Fax
(501) 760-2739
NPI assigned
Nov 2, 2006
Last updated
Jun 15, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Authorized official

Name
Brenda Larie Southerland
Title
Office Manager
Phone
(501) 625-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1629 Airport Rd
Suite B
Hot Springs, AR 71913-7951

Mailing address

1661 Airport Rd
Suite D
Hot Springs, AR 71913-7951
Phone (501) 625-7500

Other identifiers 2

IdentifierTypeStateIssuer
139989002MedicaidAR
CG9647OtherARRR MEDICARE

Other names 1

  • Hamilton West Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315001542 AR Part B Supplier - Clinic/Group Practice 5698665685 Receives reassigned benefits from 92 practitioners
25 other NPIs on this enrollment
Practice locations: Amity, AR; Hot Springs, AR; Norman, AR; Pearcy, AR; Poyen, AR

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 15

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

View all 15

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
04D0701554Hamilton West Family Medicine1629 Airport Road Suite B, Hot Springs, AR 71913ComplianceMay 17, 2027

National Provider Directory

National Provider Directory

Locations

1629 Airport Rd
Ste D
Hot Springs National Park, AR 71913
Phone (501) 767-2220

2233 Albert Pike Rd
Ste D
Hot Springs National Park, AR 71913
Phone (501) 359-3099

Practitioners & affiliated clinicians

Practitioners 92

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 92

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1821176934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 AIRPORT RD",
            "address_2": "SUITE D",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719137951",
            "telephone_number": "501-625-7500",
            "fax_number": "501-625-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 AIRPORT RD",
            "address_2": "SUITE B",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719137951",
            "telephone_number": "501-767-0075",
            "fax_number": "501-760-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSTAR PHYSICIANS OF HOT SPRINGS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "SOUTHERLAND",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "LARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "501-625-7500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139989002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CG9647",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hamilton West Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hot Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; 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.