NPIMap

Organization Active NPI

White River Health System, Inc

Doing business as Stone County Medical Center Swing Bed

  • Medicare Defined Swing Bed Hospital Unit
  • Mountain View, AR
National Provider Identifier
1902862915
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
WHITE RIVER HEALTH SYSTEM, INC
Doing business as
Stone County Medical Center Swing Bed
Practice address
2106 E. Main St.
Mountain View, AR 72560-6439
Phone
(870) 269-4361
Fax
(870) 269-3093
NPI assigned
Apr 26, 2006
Last updated
May 2, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WHITE RIVER HEALTH SYSTEM, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Authorized official

Name
Shawna Baxter
Title
Provider Enrollment
Phone
(870) 262-5545

Specialties & licenses 1

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

Addresses

Primary practice location

2106 E. Main St.
Mountain View, AR 72560-6439

Mailing address

1710 Harrison St
Batesville, AR 72501-7303
Phone (870) 262-4361

Other identifiers 1

IdentifierTypeStateIssuer
1Z310OtherARBCBS

Other names 1

  • STONE COUNTY MEDICAL CENTER SWING BED Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061228000257 AR Part A Provider - Critical Access Hospital 0143134270 Practice locations: Mountain View, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902862915. Details of each certification follow.

Hospital certification: CCN 04Z310

Legal name
WHITE RIVER HEALTH SYSTEM, INC.
Doing business as
STONE COUNTY MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Aug 17, 1999 in AR
Enrollment address
2106 East Main
Stone County Medical Center
Mountain View, AR 72560-6439
Other Hospital Practice Location

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

National Provider Directory

National Provider Directory
Tax ID family
WRMC Patient Care Clini48 organizations share this tax ID, including this one
Part of
WRMC Patient Care Clini

Other organizations with this tax ID 47

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

View all 47

Ownership & related parties

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
White River Health System, Inc. Organization, Batesville, AR 5% Or Greater Direct Ownership Interest Apr 1, 1999
Steve Case Individual Corporate Officer Jan 1, 2009
Corporate Director Jan 1, 2009
Philip Brissey Individual Corporate DirectorBoard Member Feb 8, 2013
Rick Elumbaugh Individual Corporate Director Jan 1, 2022
Paula Terrell Individual Corporate DirectorBoard Memeber Jan 1, 2014
Robert McIntire Individual Corporate Director Jan 1, 2022
Jason Taylor Individual Corporate Director Jan 1, 2022
Tina Wheelis Individual Corporate Director Jan 1, 2022
Jeff Showalter Individual Corporate DirectorBoard Member Jan 1, 2013
Kevin S Rose Individual Corporate DirectorBoard Member Jan 1, 2014
Randy Cross Individual Corporate Director Jan 1, 2022
Heather Billingsley Individual W-2 Managing Employee Mar 1, 2018
OtherContract Compliance Specialist Mar 1, 2018
Robert Wright Individual Corporate Officer Jan 1, 2017
Corporate Director Jan 1, 2017
W-2 Managing Employee Jan 1, 2017
William Tyler Fowlkes Individual Corporate Director Jan 1, 2022

All facility ownership & control disclosures 16

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

FacilityTypeRoleSince
White River Medical CenterBatesville, AR, CCN 040119 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jan 31, 1976
Jan 31, 1976
Stone County Medical CenterMountain View, AR, CCN 041310 Hospital Operational/Managerial Control Jan 1, 2008
White River Medical CenterBatesville, AR, CCN 04S119 Hospital Operational/Managerial Control Dec 21, 2007
White River Medical Center Rehabilitation UnitBatesville, AR, CCN 04T119 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1976
Midway Medical ClinicCherokee Village, AR, CCN 043981 Rural health clinic Operational/Managerial Control (100%) Sep 10, 2010
Melbourne Medical ClinicMelbourne, AR, CCN 043997 Rural health clinic Operational/Managerial Control Oct 16, 2007
Drasco Medical ClinicDrasco, AR, CCN 043455 Rural health clinic 5% Or Greater Direct Ownership Interest Jul 12, 1996
Cave City Medical ClinicCave City, AR, CCN 043982 Rural health clinic Operational/Managerial Control Nov 19, 1991
Plesant Plains Medical ClinicPleasant Plains, AR, CCN 043422 Rural health clinic Operational/Managerial Control Jul 1, 2006
White River Health Family CareMountain View, AR, CCN 043884 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2015
Sugarloaf Medical ClinicHeber Springs, AR, CCN 043914 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2021
White River Health Family CareNewark, AR, CCN 048540 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2023
White River Health Family CareBatesville, AR, CCN 048539 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2023
White River Health Family CareSouthside, AR, CCN 048541 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2023
White River Health Care FamilyBatesville, AR, CCN 048542 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2023
White River Health Children's ClinicBatesville, AR, CCN 048543 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2023

Facilities with the same owner 16

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

View all 16

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1902862915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 HARRISON ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017303",
            "telephone_number": "870-262-4361",
            "fax_number": "870-262-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 E. MAIN ST.",
            "city": "MOUNTAIN VIEW",
            "state": "AR",
            "postal_code": "725606439",
            "telephone_number": "870-269-4361",
            "fax_number": "870-269-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE RIVER HEALTH SYSTEM, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHITE RIVER HEALTH SYSTEM, INC.",
        "enumeration_date": "2006-04-26",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "SHAWNA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "870-262-5545"
    },
    "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": "BCBS",
            "identifier": "1Z310",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STONE COUNTY MEDICAL CENTER SWING BED",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "STONE COUNTY MEDICAL CENTER SWING BED",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mountain View, AR

Sources for this page

Verify at the official NPI Registry.