NPIMap

Organization Active NPI

Healthstar Physicians of Hot Springs, PLLC

Doing business as HSP - Poyen School Based Clinic

  • Family Medicine Physician
  • Poyen, AR
National Provider Identifier
1932709995
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HEALTHSTAR PHYSICIANS OF HOT SPRINGS, PLLC
Doing business as
HSP - Poyen School Based Clinic
Practice address
505 W Section Line Road
Poyen, AR 72128
Phone
(501) 332-5529
NPI assigned
Oct 29, 2020
Last updated
Oct 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Authorized official

Name
Brenda Larie Southerland
Title
Cfo
Phone
(501) 625-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

505 W Section Line Road
Poyen, AR 72128

Mailing address

1661 Airport Rd Ste D
Hot Springs, AR 71913-8184
Phone (501) 625-7500

Other names 1

  • HSP - Poyen School Based Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315001542 AR Part B Supplier - Clinic/Group Practice 5698665685 Receives reassigned benefits from 92 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Amity, AR; Hot Springs, AR; Norman, AR; Pearcy, AR; Poyen, AR

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
West Shore Medical Clin12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603929600000",
    "number": "1932709995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 AIRPORT RD STE D",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719138184",
            "telephone_number": "501-625-7500",
            "fax_number": "501-625-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 W SECTION LINE ROAD",
            "city": "POYEN",
            "state": "AR",
            "postal_code": "72128",
            "telephone_number": "501-332-5529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSTAR PHYSICIANS OF HOT SPRINGS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "SOUTHERLAND",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "LARIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "501-625-7500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HSP - Poyen School Based Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poyen, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.