BAXTER REGIONAL CENTER FOR INTEGRATIVE MEDICINE, LLC
NPI 1922475045
Family Medicine in Mountain Home, AR

NPI Status: Active since August 24, 2015

Contact Information

610 BROADMOOR DR
MOUNTAIN HOME, AR
ZIP 72653
Phone: (870) 508-7530

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  • Organization
  • Family Medicine
  • CLIA Number: 04D0692424
  • CLIA Cert. Type: Hospital
  • CLIA Exp. Date: 09-05-2025

About BAXTER REGIONAL CENTER FOR INTEGRATIVE MEDICINE, LLC

This page provides the complete NPI Profile along with additional information for Baxter Regional Center For Integrative Medicine, Llc, a primary care provider established in Mountain Home, Arkansas operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1922475045 assigned on August 2015. The practitioner's primary taxonomy code is 207Q00000X with license number E2090 (AR). The provider is registered as an organization and their NPI record was last updated 10 years ago. Baxter Regional Center For Integrative Medicine, Llc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Mr. Ron Peterson (Manager)

NPI
1922475045
Provider Name
BAXTER REGIONAL CENTER FOR INTEGRATIVE MEDICINE, LLC
Entity Type
Organization
Location Address
610 BROADMOOR DR MOUNTAIN HOME, AR 72653
Location Phone
(870) 508-7530
Mailing Address
610 BROADMOOR DR MOUNTAIN HOME, AR 72653
Mailing Phone
(870) 508-7530
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-24-2015
Last Update Date
08-24-2015
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A primary care provider (PCP) like Baxter Regional Center For Integrative Medicine, Llc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
E2090
License State
AR
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. RON PETERSON

Authorized Official Title
MANAGER
Authorized Official Phone
(870) 508-1018

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
04D0692424
Facility Type
Hospital
Certificate Effective Date
September 06, 2023
Certificate Expiration Date
September 05, 2025
Laboratory Director
DR. CHRISTOPHER G. WEBB
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Baxter Regional Center For Integrative Medicine, Llc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1922475045
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2942871008
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 4 + 2 + 8 + 7 + 1 + 0 + 0 + 8 + 24 = 65
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 65 = 55

The NPI number 1922475045 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1265820872 ROBIN KEATING MASSAGE THERAPIST
Individual
Massage Therapist610 BROADMOOR DR
MOUNTAIN HOME, AR 72653
(870) 508-7530
1902286321 MARY DANFORTH
Individual
Dietitian, Registered610 BROADMOOR DR
MOUNTAIN HOME, AR 72653
(870) 508-7530

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1922475045, enumerated in the NPI registry as an "organization" on August 24, 2015

The provider is located at 610 Broadmoor Dr Mountain Home, Ar 72653 and the phone number is (870) 508-7530

This medical organization specializes in Family Medicine with taxonomy code 207Q00000X

The provider's CLIA number is 04D0692424 for a "hospital" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing..

This NPI record was last updated on August 24, 2015. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.