NPIMap

Organization Active NPI

Baxter County Regional Hospital, Inc

Doing business as Baxter Health

  • General Acute Care Hospital
  • Mountain Home, AR
National Provider Identifier
1881788933
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
BAXTER COUNTY REGIONAL HOSPITAL, INC
Doing business as
Baxter Health
Practice address
624 Hospital Dr
Mountain Home, AR 72653-2955
Phone
(870) 508-1000
NPI assigned
Oct 3, 2006
Last updated
Mar 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU Primary
Ambulance 341600000X 110 AR

Addresses

Primary practice location

624 Hospital Dr
Mountain Home, AR 72653-2955

Mailing address

624 Hospital Dr
Mountain Home, AR 72653-2955
Phone (870) 508-1000

Other identifiers 1

IdentifierTypeStateIssuer
101001105MedicaidAR

Other names 1

  • Baxter Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060907000519 AR Part A Provider - Hospital 3274420971 1 other NPI on this enrollment
Practice locations: Mountain Home, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881788933. Details of each certification follow.

Hospital certification: CCN 040027

Legal name
BAXTER COUNTY REGIONAL HOSPITAL INC
Doing business as
BAXTER HEALTH
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Feb 28, 2025
Beds
268
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1963 in AR
Enrollment address
624 Hospital Dr
Mountain Home, AR 72653-2955
Other Hospital Practice Location
Hospital subgroups
General

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

Other NPIs with the same Medicare PAC ID 16

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

View all 16

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Baxter HealthCCN 040027 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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

Locations

761 Beard Dr
Mountain Home, AR 72653

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Sally Gilbert Individual Other Jul 1, 2023
Melissa B Dirst-Roberts Individual Other Jul 1, 2023
Rondell Peterson Individual Corporate Director Jun 1, 2007
Debra Henry Individual Corporate DirectorCfo Jan 1, 2017
Baxter County Regional Hospital Inc Organization, Mountain Home, AR Corporation Operational/Managerial Control Nov 1, 1966
Jason Lindsay Individual Other Jul 1, 2023
Heather Knight Loftis Individual Other Jul 1, 2023
Lang Zimmerman Individual Other Jul 1, 2023
Steve Luelf Individual Other Jul 1, 2023
Paul Wade Individual Other Jul 1, 2023
Lucinda Crow Individual W-2 Managing Employee Jul 12, 2015
Nicole Vaccarella Individual Corporate DirectorVP/General Councel Jan 1, 2017
Ted Sanders Individual Corporate Director Jan 1, 2012
Randy Hopper Individual Other Jul 1, 2023
Jerry Cunningham Individual Other Jul 1, 2023

Owners & managing parties with NPI records 18

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 18

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Baxter Health Family Clinic at Calico RockCalico Rock, AR, CCN 048559 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2025
Baxter Health Family ClinicMountain Home, AR, CCN 048558 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2025
Baxter Health Family Clinic at MelbourneMelbourne, AR, CCN 048555 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2025
Baxter Health Family Clinic at Mountain ViewMountain View, AR, CCN 048556 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2025
Baxter Health Market Street Family ClinicMountain Home, AR, CCN 048557 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2025

Owned or controlled facilities with NPI records 6

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

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 12

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 405

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 405

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1881788933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 HOSPITAL DR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532955",
            "telephone_number": "870-508-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 HOSPITAL DR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532955",
            "telephone_number": "870-508-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAXTER COUNTY REGIONAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "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": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "AR",
            "license": "110",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101001105",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baxter Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mountain Home, AR

Sources for this page

Verify at the official NPI Registry.