Five Rivers Medical Center Inc
Organization Active NPI Rural Health Clinic/Center · Pocahontas, AR
NPI 1982157020 · NPPES record last updated Jul 5, 2024
Key facts
- NPI
- 1982157020
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- FIVE RIVERS MEDICAL CENTER INC
- Practice address
- 2018 Highway 67 S
Pocahontas, AR 72455-4169 - Phone
- (870) 202-1048
- NPI assigned
- Jul 25, 2016
- Organization subpart
- Yes
- Parent organization (as reported)
- FIVE RIVERS MEDICAL CENTER INC
Authorized official
- Name
- Randall Dewayne Barymon
- Title
- Ceo
- Phone
- (870) 892-6200
Owners & managing parties with NPI records 5
Owned or controlled facilities with NPI records 4
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 7
Related certifications (CCN) 1
Facilities with the same owner 10
Practitioners 43
-
Christina Adams, RNP
-
Elizabeth Fike, DO
-
Jordan Kent Janik, M.D.
-
Philip Anthony Jansen, M.D.
-
Lauren Danielle Lance, APRN
-
Damian Allen, M.D.
-
Erica Nicole Baker, D.O.
-
Tyeler Barker, MD
-
Joshua Barnett, M.D.
-
Ronald Wayne Barnett Jr., M.D.
-
Christopher Edward Brown, M.D.
-
Russell Counce, CRNA
-
Mickey Brian Deel, D.O.
-
Amirtharaj Dhanaraja, M.D.
-
Tia Ellen Franklin, CRNA
-
Matthew L Ledden, CRNA
-
Xiaolong Liu, DO
-
Emmanuel Macdonald, M.D.
-
Roger A McMillan III, CRNA
-
Tara H Rahmlow, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
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
- Corporation · Non-profit
- Incorporated
- Nov 1, 2010 in AR
- Enrollment address
- 2018 Highway 67 S
Pocahontas, AR 72455-4169 - Related CCNs
- 040779
All disclosed owners & managing parties 6
| Name | Role | Since | Share |
|---|---|---|---|
| St Bernards Healthcare Inc |
Operational/Managerial Control | Feb 22, 2019 | |
| Five Rivers Medical Center Inc |
Operational/Managerial Control | Nov 1, 2010 | |
| Chris Barber |
Corporate Officer |
Jan 1, 2020 | |
| Corporate Director |
Jan 1, 2020 | ||
| Gary Childers |
Corporate Officer |
Jan 1, 2020 | |
| Randall Barymon |
Corporate Officer | Jan 1, 2024 | |
| Corporate Director | Jan 1, 2024 | ||
| W-2 Managing Employee |
Jan 1, 2024 | ||
| Operational/Managerial Control | Jan 1, 2024 | ||
| Veronica Melnyk |
Corporate Officer |
Feb 22, 2019 |
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| St. Bernards Five Rivers Medical Center |
Hospital | Operational/Managerial Control (100%) | Aug 23, 2007 |
| St. Bernards Five Rivers Medical Center |
Hospital | Operational/Managerial Control (100%) | Aug 23, 2007 |
| St. Bernards Five Rivers Medical Center |
Hospital | Operational/Managerial Control | Jul 1, 1966 |
| Five Rivers Medical Center Home Health |
Home health agency | Operational/Managerial Control (100%) | Jan 1, 2011 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160823002822 | AR | Part a Provider - Rural Health Clinic | 1456540194 | Practice locations: Pocahontas, AR |
National Provider Directory
- Tax ID family
- Five Rivers Medical Center
- Part of
- Five Rivers Medical Center
Locations
2018 Highway 67 S
Pocahontas, AR 72455
Phone (870) 202-1048
Interoperability endpoints
- bbooker@frmc.medalliesdirect.net
- jjanik@frmc.medalliesdirect.net
- llance@frmc.medalliesdirect.net
- pjansen@frmc.medalliesdirect.net
- bzenger@frmc.medalliesdirect.net
- mshatley@frmc.medalliesdirect.net
- sfoster@frmc.medalliesdirect.net
- cadams@frmc.medalliesdirect.net
- malbertson@frmc.medalliesdirect.net
- efike@frmc.medalliesdirect.net
- dsommer@frmc.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes |
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
- Five Rivers Medical Clinic
- St. Bernards Five Rivers Medical Clinic
Other providers in Pocahontas, AR
- Patricia Leah Evers
- Families, Inc. of Arkansas
- Family Dental Care of Pocahontas Inc
- Five Rivers Medical Center
- Five Rivers Medical Center Inc
- Five Rivers Medical Center Inc.
- Five Rivers Medical Center Inc.
- Five Rivers Medical Center Inc.
- Five Rivers Medical Center Inc.
- Five Rivers Medical Center Inc.
All providers in Pocahontas, AR · Rural Health Clinic/Center in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 5, 2024. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.