Healthstar Physicians of Hot Springs, PLLC
Organization Active NPI Family Medicine Physician · Pearcy, AR
NPI 1962004093 · NPPES record last updated Dec 10, 2020
Key facts
- NPI
- 1962004093
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- HEALTHSTAR PHYSICIANS OF HOT SPRINGS, PLLC
- Practice address
- 205 Wolf St
Pearcy, AR 71964-9449 - Phone
- (501) 767-2306
- NPI assigned
- Nov 13, 2020
- Organization subpart
- No
Authorized official
- Name
- Brenda Larie Southerland
- Title
- Cfo
- Phone
- (501) 625-7500
Other NPIs on the same Medicare enrollment 15
Corporate family (same tax ID) 11
Practitioners 6
-
Christine Marie Miles, APRN
-
Kelsey Montgomery, APRN
-
Courtney Ann Huneycutt, CPNP
-
Natalie S. Manatt, APRN
-
Billie E Pool, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- West Shore Medical Clin
Locations
1661 Airport Rd
Ste F
Hot Springs National Park, AR 71913
Phone (501) 651-4300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
205 Wolf St
Pearcy, AR 71964-9449
Mailing address
1661 Airport Rd Ste D
Hot Springs, AR 71913-8184
Phone (501) 625-7500
Other names
- HSP Wolf Clinic
Other providers in Pearcy, AR
- Eric Carrouth
- Carrouthrx
- Emrha LLC
- Samantha Mosher Galster
- Lucas William Harp
- Lauren Elizabeth Holland
- J. Michael Plyler, DDS, PA
- Michael Ryan Jones
- Lake Hamilton School District
- Julie Lynn Logan
All providers in Pearcy, AR · Family Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.