Baxter Regional Enterprises, LLC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

BAXTER REGIONAL ENTERPRISES, LLC

Doing business as

Baxter Health Urology Clinic

Practice address

15 Green Valley Dr Ste 100
Mountain Home, AR 72653-8102

Phone

(870) 701-0490

Fax

(870) 701-0491

NPI assigned

Apr 24, 2024

Last updated

Apr 24, 2024By the provider in NPPES

Organization subpart

No

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

Addresses

Other names 1

• Baxter Health Urology Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

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

• Baxter Regional Enterprises, LLC

  dba Baxter Regional Cardiovascular Clinic

  • Specialist
  • Mountain Home, AR
  • NPI 1265197651

  O20220121001564

  Same enrollment
• Baxter Regional Enterprises, LLC

  dba Baxter Health Cardiology Clinic at Harrison

  • Clinic/Center
  • Harrison, AR
  • NPI 1689556839

  O20220121001564

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Baxter Health Cardiology Clinic at Harrison3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Baxter Regional Enterprises, LLC

  dba Baxter Health ENT and Allergy Clinic

  • Otolaryngology Physician
  • Mountain Home, AR
  • NPI 1467313999
  NPD tax ID
• Baxter Regional Enterprises, LLC

  dba Baxter Health Cardiology Clinic at Harrison

  • Clinic/Center
  • Harrison, AR
  • NPI 1689556839
  NPD tax ID

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.

• Ronald E Revard, MD

  • Cardiovascular Disease Physician
  • Harrison, AR
  • NPI 1710970637
  NPD
• Angelina Nicole-Marie Denton-Howell, FNP

  • Family Nurse Practitioner
  • Springfield, MO
  • NPI 1760106868
  NPD

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1982450706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 GREEN VALLEY DR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726538102",
            "telephone_number": "870-701-0490",
            "fax_number": "870-701-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 GREEN VALLEY DR STE 100",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726538102",
            "telephone_number": "870-701-0490",
            "fax_number": "870-701-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAXTER REGIONAL ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "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": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baxter Health Urology Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Baxter Day Service Center, Inc.
• Baxter Emergency Group PLLC
• Baxter Regional Center for Integrative Medicine, LLC
• Baxter Regional Enterprises, LLC (Baxter Regional Cardiovascular Clinic)
• Baxter Regional Enterprises, LLC (Baxter Health ENT and Allergy Clinic)
• Baxter Retirement Village
• BCC Mountain Home Operations, LLC (Elmcroft of Mountain Home)
• Catherine Beauchamp, RN
• Austin Beavers, QBHP
• Denise Rae Beeson, APN

• Urology Physician in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• Urology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.