NPIMap

Organization Active NPI

McGehee Hospital Incorporated

  • Medicare Defined Swing Bed Hospital Unit
  • McGehee, AR
National Provider Identifier
1861711301
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
MCGEHEE HOSPITAL INCORPORATED
Practice address
900 S 3Rd St
MC Gehee, AR 71654-2562
Phone
(870) 222-5600
Fax
(870) 690-4239
NPI assigned
May 24, 2010
Last updated
Aug 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Authorized official

Name
Mr. Terry L Amstutz, MHSA
Title
Ceo
Phone
(870) 690-4132

Specialties & licenses 1

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

Addresses

Primary practice location

900 S 3Rd St
MC Gehee, AR 71654-2562

Mailing address

PO Box 351
MC Gehee, AR 71654-0351
Phone (870) 222-5600

Other identifiers 2

IdentifierTypeStateIssuer
AR4657OtherARLICENSE
1Z308OtherARBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100820000915 AR Part A Provider - Critical Access Hospital 5395876361 Receives reassigned benefits from 5 practitioners
Practice locations: McGehee, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861711301. Details of each certification follow.

Hospital certification: CCN 04Z308

Legal name
MCGEHEE HOSPITAL INCORPORATED
Doing business as
MCGEHEE HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Dec 29, 2009 in AR
Enrollment address
900 S 3Rd St
McGehee Hospital
McGehee, AR 71654-2526
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
McGehee Hospial Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Clarissa Herren Individual Corporate DirectorBoard Member Jan 1, 2011
Andrew Wargo Individual Corporate DirectorBoard Member Jul 1, 2010
Eddie Allen Individual Corporate DirectorBoard Member Jul 1, 2010
Alfonzo Dixon Individual Corporate DirectorBoard Member Jul 1, 2010
Carla Taylor Individual W-2 Managing EmployeeRevenue Cycle Manager Jul 1, 2010
Don M Smith Individual Corporate Director Mar 1, 2015
Terry Amstutz Individual Contracted Managing EmployeeCeo Jan 7, 2019
Corporate OfficerCeo Jan 7, 2019
Lisa M Hutchison Individual Corporate DirectorBoard Member Aug 20, 2019

Practitioners & affiliated clinicians

Practitioners 6

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.

Affiliated clinicians 3

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": "1274659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660003200000",
    "number": "1861711301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 351",
            "city": "MC GEHEE",
            "state": "AR",
            "postal_code": "716540351",
            "telephone_number": "870-222-5600",
            "fax_number": "870-222-4260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S 3RD ST",
            "city": "MC GEHEE",
            "state": "AR",
            "postal_code": "716542562",
            "telephone_number": "870-222-5600",
            "fax_number": "870-690-4239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCGEHEE HOSPITAL INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-24",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A",
        "authorized_official_last_name": "AMSTUTZ",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-690-4132",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MHSA"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AR4657",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1Z308",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McGehee, AR

Sources for this page

Verify at the official NPI Registry.