NPIMap

Organization Active NPI

Five Rivers Medical Center Inc.

Doing business as St. Bernards Five Rivers Medical Center

  • Psychiatric Hospital Unit
  • Pocahontas, AR
National Provider Identifier
1932401650
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
FIVE RIVERS MEDICAL CENTER INC.
Doing business as
St. Bernards Five Rivers Medical Center
Practice address
2801 Medical Center Dr
Pocahontas, AR 72455-9436
Phone
(870) 892-6000
Fax
(870) 892-8100
NPI assigned
Dec 1, 2010
Last updated
Dec 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Authorized official

Name
Matt Nichols
Title
Cfo
Phone
(870) 892-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X NU Primary

Addresses

Primary practice location

2801 Medical Center Dr
Pocahontas, AR 72455-9436

Mailing address

2801 Medical Center Dr
Pocahontas, AR 72455-9436
Phone (870) 892-6000

Other names 1

  • ST. BERNARDS FIVE RIVERS MEDICAL CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110111000867 AR Part A Provider - Hospital 1456540194 Practice locations: Pocahontas, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932401650. Details of each certification follow.

Hospital certification: CCN 04S047

Legal name
FIVE RIVERS MEDICAL CENTER INC
Doing business as
ST. BERNARDS FIVE RIVERS MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Nov 2, 2010 in AR
Enrollment address
2801 Medical Center Dr
Pocahontas, AR 72455-9436
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Five Rivers Medical Center Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

2801 Medical Center Dr
Pocahontas, AR 72455
Phone (870) 892-6000

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
St Bernards Healthcare Inc Organization, Jonesboro, AR Non-profit Operational/Managerial Control Feb 22, 2019
Five Rivers Medical Center Inc Organization, Pocahontas, AR Corporation, Non-profit Operational/Managerial Control Aug 23, 2007 100%
Chris Barber Individual Corporate OfficerChairman Jan 1, 2020
Corporate DirectorChairman Jan 1, 2020
Gary Childers Individual Corporate OfficerBoard Member Jan 1, 2020
Randall Barymon Individual Corporate Officer Feb 1, 2024
Corporate Director Feb 1, 2024
W-2 Managing Employee Feb 1, 2024
Operational/Managerial Control Feb 1, 2024
Other Feb 1, 2024
Veronica Melnyk Individual Corporate OfficerBoard Member Jan 1, 2020

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
St. Bernards Five Rivers Medical CenterPocahontas, AR, CCN 04U047 Hospital Operational/Managerial Control (100%) Aug 23, 2007
St. Bernards Five Rivers Medical CenterPocahontas, AR, CCN 040779 Hospital Operational/Managerial Control Jul 1, 1966
Five Rivers Medical Center Home HealthPocahontas, AR, CCN 047148 Home health agency Operational/Managerial Control (100%) Jan 1, 2011
St. Benards Five Rivers Medical ClinicPocahontas, AR, CCN 048516 Rural health clinic Operational/Managerial Control Nov 1, 2010

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 10

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

NPI Registry JSON

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1932401650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 MEDICAL CENTER DR",
            "city": "POCAHONTAS",
            "state": "AR",
            "postal_code": "724559436",
            "telephone_number": "870-892-6000",
            "fax_number": "870-892-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 MEDICAL CENTER DR",
            "city": "POCAHONTAS",
            "state": "AR",
            "postal_code": "724559436",
            "telephone_number": "870-892-6000",
            "fax_number": "870-892-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE RIVERS MEDICAL CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-01",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "870-892-6000"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST. BERNARDS FIVE RIVERS MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pocahontas, AR

Sources for this page

Verify at the official NPI Registry.