NPIMap

Organization Active NPI

Arkansas Methodist Hospital Corporation

Doing business as Paragould Anesthesia Group

  • Anesthesiology Physician
  • Paragould, AR
National Provider Identifier
1861593816
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ARKANSAS METHODIST HOSPITAL CORPORATION
Doing business as
Paragould Anesthesia Group
Practice address
900 W Kingshighway
Paragould, AR 72450-5942
Phone
(870) 239-7000
NPI assigned
Sep 25, 2006
Last updated
Jul 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Authorized official

Name
Barry Davis
Title
Ceo
Phone
(870) 239-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

900 W Kingshighway
Paragould, AR 72450-5942

Mailing address

925 Sherwood Dr
Lake Bluff, IL 60044-2203

Other identifiers 3

IdentifierTypeStateIssuer
CD7206OtherARRAILROAD MEDICARE
5C489OtherARBCBS OF ARKANSAS
1025850002MedicaidAR

Other names 1

  • PARAGOULD ANESTHESIA GROUP Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031124000746 AR Part B Supplier - Clinic/Group Practice 6608780119 Receives reassigned benefits from 26 practitioners
Practice locations: Paragould, AR

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Donald W Blair8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baptist Memorial Hospital - ParagouldParagould, AR, CCN 040039 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 30, 1999
Baptist Memorial Hospital - ParagouldParagould, AR, CCN 04T039 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 30, 1999
Baptist Memorial Hospital - Paragould Home HealthParagould, AR, CCN 047004 Home health agency 5% Or Greater Direct Ownership Interest (100%) Apr 30, 1999

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 38

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 38

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626393600000",
    "number": "1861593816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 SHERWOOD DR",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600442203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W KINGSHIGHWAY",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724505942",
            "telephone_number": "870-239-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS METHODIST HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-239-7000"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD7206",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ARKANSAS",
            "identifier": "5C489",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1025850002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PARAGOULD ANESTHESIA GROUP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PARAGOULD ANESTHESIA GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paragould, AR

Sources for this page

Verify at the official NPI Registry.