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Baxter County Regional Hospital, Inc

Organization Active NPI Rural Health Clinic/Center · Mountain Home, AR

NPI 1891590154 · NPPES record last updated Jul 24, 2026

Key facts

NPI
1891590154
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
BAXTER COUNTY REGIONAL HOSPITAL, INC
Practice address
899 Burnett Dr
Mountain Home, AR 72653-2909
Phone
(870) 425-6212
Fax
(870) 508-6896
NPI assigned
Feb 19, 2025
Organization subpart
No

Authorized official

Name
Debra Henry
Title
Cfo
Phone
(870) 508-1003

Owners & managing parties with NPI records 18

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

Owned or controlled facilities with NPI records 6

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

Other NPIs on the same Medicare enrollment 7

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

Other NPIs with the same Medicare PAC ID 16

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

Corporate family (same tax ID) 39

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

View all 39

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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

Facilities with the same owner 5

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

Practitioners 57

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 57

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in AR

Rural health clinic certification: CCN 048558

Legal name
BAXTER COUNTY REGIONAL HOSPITAL INC
Doing business as
BAXTER HEALTH FAMILY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 5, 2025
Last certification
Nov 5, 2025
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Enrollment address
899 Burnett Dr
Mountain Home, AR 72653-2909
Related CCNs
040027

All disclosed owners & managing parties 14

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 		Corporate Director
Board of Director		 Mar 1, 2010
Melissa B Dirst-Roberts
Individual 		Corporate Director
Board of Director		 Jan 1, 2023
Rondell Peterson
Individual 		Corporate Officer
Ceo		 Jun 1, 2007
Corporate Director
Ceo		 Jun 1, 2007
W-2 Managing Employee
Ceo		 Jun 1, 2007
Debra Henry
Individual 		Corporate Officer
Cfo		 Jun 1, 2016
Corporate Director
Cfo		 Jun 1, 2016
W-2 Managing Employee
Cfo		 Jun 1, 2016
Baxter County Regional Hospital Inc
Organization · Mountain Home, AR
Corporation, Non-profit 		5% Or Greater Direct Ownership Interest Mar 1, 2025 100%
Heather Knight Loftis
Individual 		Corporate Director
Board of Director		 Dec 1, 2021
Lang Zimmerman
Individual 		Corporate Director
Board of Director		 Nov 1, 2016
Steve Luelf
Individual 		Corporate Director
Board of Director		 Nov 1, 2005
Paul Wade
Individual 		Corporate Director
Board of Director		 May 1, 2017
Nicole Vaccarella
Individual 		W-2 Managing Employee
VP General Counsel		 Mar 1, 2000
Ted Sanders
Individual 		Corporate Director
Board of Director		 Jan 1, 2008
Randy Hopper
Individual 		Corporate Director
Board of Director		 Jan 1, 2019
Matthew Baker Wilson
Individual 		Corporate Director
Board of Director		 Jan 1, 2025
Jerry Cunningham
Individual 		Corporate Director
Board of Director		 Oct 1, 2011

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
Mountain Home, AR · CCN 040027		 Hospital Operational/Managerial Control Nov 1, 1966
Baxter Health Family Clinic at Calico Rock
Calico Rock, AR · CCN 048559		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2025
Baxter Health Family Clinic at Melbourne
Melbourne, AR · CCN 048555		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2025
Baxter Health Family Clinic at Mountain View
Mountain View, AR · CCN 048556		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2025
Baxter Health Market Street Family Clinic
Mountain Home, AR · CCN 048557		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2025

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050607001085 AR Part B Supplier - Clinic/Group Practice 3274420971 Receives reassigned benefits from 32 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Calico Rock, AR; Harrison, AR; Mammoth Spring, AR; Melbourne, AR; Mountain Home, AR; Mountain View, AR; Yellville, AR
O20250402001956 AR Part a Provider - Rural Health Clinic 3274420971 Practice locations: Mountain Home, AR

National Provider Directory

Tax ID family
BCRH ER Prof Fees (40 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207Q00000X
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

899 Burnett Dr
Mountain Home, AR 72653-2909

Mailing address

PO Box 707
Mountain Home, AR 72654-0707
Phone (870) 424-7070

Other names

  • Baxter Health Family Clinic Doing business as

Other providers in Mountain Home, AR

All providers in Mountain Home, AR · Rural Health Clinic/Center in Arkansas

Sources for this page

Verify at the official NPI Registry.