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Organization Active NPI

Baxter County Regional Hospital, Inc

Doing business as Baxter Health Internal Medicine & Infectious Disease Clinic

  • Internal Medicine Physician
  • Mountain Home, AR
National Provider Identifier
1982273512
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BAXTER COUNTY REGIONAL HOSPITAL, INC
Doing business as
Baxter Health Internal Medicine & Infectious Disease Clinic
Practice address
628 Hospital Dr
Suite Ground C
Mountain Home, AR 72653-2937
Phone
(870) 508-7450
Fax
(870) 508-7768
NPI assigned
Jun 18, 2021
Last updated
Aug 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Authorized official

Name
Debra Henry
Title
Cfo
Phone
(870) 508-1003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

628 Hospital Dr
Suite Ground C
Mountain Home, AR 72653-2937

Mailing address

628 Hospital Dr
Suite Ground C
Mountain Home, AR 72653-2937
Phone (870) 508-7450

Other names 1

  • Baxter Health Internal Medicine & Infectious Disease Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210807000048 AR Part B Supplier - Clinic/Group Practice 3274420971 Receives reassigned benefits from 15 practitioners
3 other NPIs on this enrollment
Practice locations: Mountain Home, AR

Other NPIs with the same Medicare PAC ID 16

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

View all 16

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Baxter Cnty Reg Hosp Inc44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

Locations

628 Hospital Dr
Ste 3-E
Mountain Home, AR 72653
Phone (870) 508-3200

628 Hospital Dr
Ste C
Mountain Home, AR 72653
Phone (870) 508-7450

Ownership & related parties

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Baxter HealthMountain Home, AR, CCN 040027 Hospital Operational/Managerial Control Nov 1, 1966
Baxter Health Family Clinic at Calico RockCalico Rock, AR, CCN 048559 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2025
Baxter Health Family ClinicMountain Home, AR, CCN 048558 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2025
Baxter Health Family Clinic at MelbourneMelbourne, AR, CCN 048555 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2025
Baxter Health Family Clinic at Mountain ViewMountain View, AR, CCN 048556 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2025
Baxter Health Market Street Family ClinicMountain Home, AR, CCN 048557 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2025

Owned or controlled facilities with NPI records 7

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

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1982273512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 HOSPITAL DR",
            "address_2": "SUITE GROUND C",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532937",
            "telephone_number": "870-508-7450",
            "fax_number": "870-508-7768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 HOSPITAL DR",
            "address_2": "SUITE GROUND C",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532937",
            "telephone_number": "870-508-7450",
            "fax_number": "870-508-7768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAXTER COUNTY REGIONAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-18",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "870-508-1003"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baxter Health Internal Medicine & Infectious Disease Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mountain Home, AR

Sources for this page

Verify at the official NPI Registry.