NPIMap

Organization Active NPI

Five Rivers Medical Center Inc

Doing business as Five Rivers Medical Clinic

  • Rural Health Clinic/Center
  • Pocahontas, AR
National Provider Identifier
1982157020
Registry record updated Jul 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FIVE RIVERS MEDICAL CENTER INC
Doing business as
Five Rivers Medical Clinic
St. Bernards Five Rivers Medical Clinic
Practice address
2018 Highway 67 S
Pocahontas, AR 72455-4169
Phone
(870) 202-1048
NPI assigned
Jul 25, 2016
Last updated
Jul 5, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
FIVE RIVERS MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 5, 2024

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

Authorized official

Name
Randall Dewayne Barymon
Title
Ceo
Phone
(870) 892-6200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

2018 Highway 67 S
Pocahontas, AR 72455-4169

Mailing address

2018 Highway 67 S
Pocahontas, AR 72455-4169
Phone (870) 202-1048

Other names 2

  • Five Rivers Medical Clinic Doing business as
  • St. Bernards Five Rivers 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
O20160823002822 AR Part A Provider - Rural Health Clinic 1456540194 Practice locations: Pocahontas, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982157020. Details of each certification follow.

Rural health clinic certification: CCN 048516

Legal name
FIVE RIVERS MEDICAL CENTER INC
Doing business as
ST. BENARDS FIVE RIVERS MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 21, 2018
Last certification
Apr 9, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Nov 1, 2010 in AR
Enrollment address
2018 Highway 67 S
Pocahontas, AR 72455-4169
Related CCNs
040779

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

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 Center8 organizations share this tax ID, including this one
Part of
Five Rivers Medical Center

Other organizations with this tax ID 7

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

Interoperability endpoints

  • Direct secure messaging: bbooker@frmc.medalliesdirect.net
  • Direct secure messaging: bzenger@frmc.medalliesdirect.net
  • Direct secure messaging: cadams@frmc.medalliesdirect.net
  • Direct secure messaging: dsommer@frmc.medalliesdirect.net
  • Direct secure messaging: efike@frmc.medalliesdirect.net
  • Direct secure messaging: jjanik@frmc.medalliesdirect.net
  • Direct secure messaging: llance@frmc.medalliesdirect.net
  • Direct secure messaging: malbertson@frmc.medalliesdirect.net
  • Direct secure messaging: mshatley@frmc.medalliesdirect.net
  • Direct secure messaging: pjansen@frmc.medalliesdirect.net
  • Direct secure messaging: sfoster@frmc.medalliesdirect.net

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 Corporation, Non-profit Operational/Managerial Control Feb 22, 2019
Five Rivers Medical Center Inc Organization, Pocahontas, AR Corporation, Non-profit Operational/Managerial Control Nov 1, 2010
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 Jan 1, 2024
Corporate Director Jan 1, 2024
W-2 Managing EmployeeAd; Jan 1, 2024
Operational/Managerial Control Jan 1, 2024
Veronica Melnyk Individual Corporate OfficerBoard Member Feb 22, 2019

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 04S047 Hospital Operational/Managerial Control (100%) Aug 23, 2007
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

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.

Practitioners & affiliated clinicians

Practitioners 11

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": "1469404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720137600000",
    "number": "1982157020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 HIGHWAY 67 S",
            "city": "POCAHONTAS",
            "state": "AR",
            "postal_code": "724554169",
            "telephone_number": "870-202-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 HIGHWAY 67 S",
            "city": "POCAHONTAS",
            "state": "AR",
            "postal_code": "724554169",
            "telephone_number": "870-202-1048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE RIVERS MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE RIVERS MEDICAL CENTER INC",
        "enumeration_date": "2016-07-25",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A",
        "authorized_official_last_name": "BARYMON",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "DEWAYNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-892-6200"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Five Rivers Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Bernards Five Rivers Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pocahontas, AR

Sources for this page

Verify at the official NPI Registry.