BAXTER COUNTY REGIONAL HOSPITAL INC — NPI 1720515737 (Board-Certified Neurosurgeon (Brain, Cranial & Spine Surgeon) in MOUNTAIN HOME, AR)

CMS-1500 Box 24J / 33a • NPI

1720515737

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

207T00000X (CMS 02)

Board-Certified Neurosurgeon (Brain, Cranial & Spine Surgeon)

Box 32 Service Location & ZIP+4

310 BUTTERCUP DR STE A, MOUNTAIN HOME, AR, 72653-2932

✓ 9-Digit EDI 837 ZIP+4 (72653-2932)

Practice Phone & Referral Fax

(870) 508-7080

Fax: (870) 508-7865

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1720515737 (BAXTER COUNTY REGIONAL HOSPITAL INC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1720515737` (NPI-2 Organization / Facility)
Provider / Legal Name	BAXTER COUNTY REGIONAL HOSPITAL INC
Plain-English Specialty	Board-Certified Neurosurgeon (Brain, Cranial & Spine Surgeon) NUCC Code: `207T00000X` (Neurological Surgery)
Certifying / Licensing Body	American Board of Neurological Surgery (ABNS)
Practice Location Address	310 BUTTERCUP DR STE A, MOUNTAIN HOME, AR, 72653-2932
Practice Telephone / Fax	Tel: (870) 508-7080 \| Fax: (870) 508-7865
Administrative Mailing Address	310 BUTTERCUP DR STE A, MOUNTAIN HOME, AR, 72653-2932
Enumeration & Last Sync	Enumerated: 2017-05-22 \| CMS Record Updated: 2022-09-20
Authorized Official	DEBRA HENRY (CFO)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

310 BUTTERCUP DR STE A, MOUNTAIN HOME, AR, 72653-2932

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Plain-English Taxonomy & CMS Crosswalk (207T00000X)

What Does Taxonomy Code 207T00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207T00000X translates to:
"Board-Certified Neurosurgeon (Brain, Cranial & Spine Surgeon)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 02 (Physician/General Surgery) • CMS Code 14 (Physician/Neurosurgery)
Certifying / Accrediting Authority: American Board of Neurological Surgery (ABNS)
Clinical Scope: Brain tumors, cerebral aneurysms, spinal cord compression, herniated discs with motor weakness, hydrocephalus, or cranial CSF leaks.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (BAXTER COUNTY REGIONAL HOSPITAL INC)

Typical CPT / Diagnostic Procedures:

Microsurgical Craniotomy for Brain Tumors & Intracranial Aneurysm Clipping/Coiling
Anterior Cervical Discectomy & Fusion (ACDF) & Lumbar Microdiscectomy
Endoscopic Skull-Base Repair of Cerebrospinal Fluid (CSF) Rhinorrhea/Otorrhea
Ventriculoperitoneal (VP) Shunt Placement for Hydrocephalus

Common Therapeutic Classes:

Dexamethasone (Cerebral Edema Reduction) & Levetiracetam (Seizure Prophylaxis)
Mannitol & Hypertonic Saline (Intracranial Pressure Management)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207T00000X` — Neurological Surgery Plain English: Board-Certified Neurosurgeon (Brain, Cranial & Spine Surgeon)	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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BAXTER COUNTY REGIONAL HOSPITAL INC (NPI #1720515737)