NPIMap

Organization Active NPI

Baptist Health Hospitals

  • Rural Health Clinic/Center
  • Stuttgart, AR
National Provider Identifier
1902004567
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BAPTIST HEALTH HOSPITALS
Practice address
1609 North Medical Drive
Stuttgart, AR 72160-3274
Phone
(870) 673-7211
Fax
(870) 673-6376
NPI assigned
Jul 5, 2007
Organization subpart
Yes
Parent organization
BAPTIST HEALTH HOSPITALSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Authorized official

Name
Troy Wells
Title
President
Phone
(501) 202-2080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X AR Primary

Addresses

Primary practice location

1609 North Medical Drive
Stuttgart, AR 72160-3274

Mailing address

11001 Executive Center Drive
Suite 200
Little Rock, AR 72211-4393
Phone (501) 812-7800

Other identifiers 2

IdentifierTypeStateIssuer
201482729MedicaidAR
136428729MedicaidAR

Other names 1

  • Baptist Health Stuttgart Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091117000652 AR Part A Provider - Rural Health Clinic 3870659246 Practice locations: Stuttgart, AR

Rural health clinic certification: CCN 043480

Legal name
BAPTIST HEALTH HOSPITALS
Doing business as
BAPTIST HEALTH - STUTTGART MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 1, 1999
Last certification
Nov 4, 2019
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Sep 1, 2008 in AR
Enrollment address
1609 North Medical Drive
Baptist Health - Stuttgart Medical
Stuttgart, AR 72160-3274
Related CCNs
040072

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Baptist Health Hospitals7 organizations share this tax ID, including this one
Part of
Baptist Health Hospitals

Other organizations with this tax ID 6

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

Locations

1703 N Buerkle St
Ste 3
Stuttgart, AR 72160
Phone (870) 674-6600

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Larry White Individual Corporate Director Jan 1, 2026
Baptist Health Organization, Little Rock, AR Non-profit Operational/Managerial Control Jan 1, 2009
Ronald Dedman Individual Corporate Director Jan 1, 2026
Lamarr Bailey Individual Corporate Director Jan 1, 2026
Herren Hickingbotham Individual Corporate Director Jan 1, 2026
Judy Simmons Henry Individual Corporate Director Jan 1, 2026
Michael Akin Individual Corporate Director Jan 1, 2026
Chris Brune Individual Corporate Director Jan 1, 2026
Troy Wells Individual Corporate Director Jan 1, 2009
W-2 Managing Employee Jul 1, 2014
Suzanne Peyton Individual Corporate Director Jan 1, 2026
John McMorran Individual Corporate Director Jan 1, 2026
Steven D Weeks Individual Corporate Director Jan 1, 2009
Lindsey Lorence Individual Corporate Director Jan 1, 2026
Steven Booth Individual Corporate Director Jan 1, 2026
David Mitchell Individual Corporate Director Jan 1, 2026
James S Jones Individual Corporate Director Jan 1, 2026
Louis M Lee Individual Corporate Director Jan 1, 2026
Teresa Howell Individual Corporate Director Jan 1, 2026
Brent Beaulieu Individual Corporate Officer Jan 18, 2018
W-2 Managing Employee Jan 18, 2018
Operational/Managerial Control Jan 18, 2018
Glenn Millner Individual Corporate Director Jan 1, 2026
Les Warren Individual Corporate Director Jan 1, 2026

Facilities with the same owner 50

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

View all 50

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743552000000",
    "number": "1902004567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DRIVE",
            "address_2": "SUITE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "501-812-7800",
            "fax_number": "501-812-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 NORTH MEDICAL DRIVE",
            "city": "STUTTGART",
            "state": "AR",
            "postal_code": "721603274",
            "telephone_number": "870-673-7211",
            "fax_number": "870-673-6376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST HEALTH HOSPITALS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST HEALTH HOSPITALS",
        "enumeration_date": "2007-07-05",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-202-2080"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201482729",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136428729",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Health Stuttgart Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stuttgart, AR

Sources for this page

Verify at the official NPI Registry.