BRMC HOMETOWN CLINICS, LLC (NPI# 1750751442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750751442 |
| Entity Type | Organization |
| Organization Name | BRMC HOMETOWN CLINICS, LLC |
| Other Organization Name | BRMC HOMETOWN CLINIC AT MOUNTAIN VIEW |
| Practice Address |
803 West Main Street Mountain View AR 72560 |
| Mailing Address |
624 Hospital Dr Mountain Home AR 72653-2955 |
| Practice Telephone | 8705081039 |
| Mailing Telephone | 8705081039 |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-10-15 |
| Authorized Official Name | RON PETERSON (CEO) |
| Authorized Official Telephone | 8705081039 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
A440508 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| BRMC Hometown Clinic at Mountain View | Doing Business As Name - Organization |
| Street Address |
803 WEST MAIN STREET |
| City | MOUNTAIN VIEW |
| State | AR |
| Zip Code | 72560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518337732 | Beverly Clark | Nurse Practitioner | 803 West Main Street, Mountain View, AR 72560 | 2015-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558979781 | Creoks Mental Health Services, Inc | Clinic/Center | 301 Industrial Road, Mountain View, AR 72560 | 2020-07-14 |
| 1194377861 | John Randolph Crone II | Physical Therapist | 103 Mountain Place Drive, Mountain View, AR 72560 | 2019-07-12 |
| 1154898161 | Candace Casey Lane | Physical Therapy Assistant | 260 Hickory Circle, Mountain View, AR 72560 | 2018-10-29 |
| 1780102210 | Janet Karen Watkins | Developmental Therapist | 1810 Ozarka College Drive, Mountain View, AR 72560 | 2017-09-05 |
| 1861928038 | Jason Nope | Registered Nurse | 217 Brewer Avenue, Mountain View, AR 72560 | 2017-05-10 |
| 1013377415 | Charles Grinder | Nurse Practitioner | 102 Mountain Place Dr Ste C, Mountain View, AR 72560 | 2016-02-26 |
| 1912365982 | Baxter Regional Health System | Family Medicine | 102 Mountain Place Drive, Suite C, Mountain View, AR 72560 | 2016-02-05 |
| 1790142859 | Baxter Regional Health System | Nurse Practitioner | 803 W Main St., Mountain View, AR 72560 | 2016-01-20 |
| 1447503941 | Mitchell's Main Street Pharmacy, Inc | Pharmacy | 214 East Main St, Mountain View, AR 72560 | 2012-10-22 |
| 1366743833 | Heather A Gilbreath | Licensed Practical Nurse | 211 Blanchard Ave., Mountain View, AR 72560 | 2010-11-15 |
| Find all providers in zip 72560 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871141945 | Cindy Crystal Wong | Nurse Practitioner | 2630 West El Camino Real, Mountain View, CA 94040 | 2019-08-30 |
| 1578037859 | Katie Lutz | Nurse Practitioner | 151 Calderon Ave Apt 182, Mountain View, CA 94041-1444 | 2019-01-19 |
| 1407335847 | Carla Sue Langston | Nurse Practitioner | 2110 E Main St, Mountain View, AR 72560-6439 | 2018-08-07 |
| 1801306485 | Jordan Evans Matthews | Nurse Practitioner | 2490 Hospital Dr Ste 309, Mountain View, CA 94040-4125 | 2017-10-09 |
| 1013377415 | Charles Grinder | Nurse Practitioner | 102 Mountain Place Dr Ste C, Mountain View, AR 72560 | 2016-02-26 |
| 1790142859 | Baxter Regional Health System | Nurse Practitioner | 803 W Main St., Mountain View, AR 72560 | 2016-01-20 |
| 1518337732 | Beverly Clark | Nurse Practitioner | 803 West Main Street, Mountain View, AR 72560 | 2015-09-30 |
| 1437557451 | Cheri Kai | Nurse Practitioner | 580 N Rengstorff Ave, Mountain View, CA 94043-2894 | 2014-12-08 |
| 1588905236 | Lisa Christine Gavin Kucera | Nurse Practitioner | 2485 Hospital Dr Ste 321, Mountain View, CA 94040-4103 | 2013-03-05 |
| 1326301177 | Heather Blythe Delagi | Nurse Practitioner | 465 Fairchild Dr Ste 112, Mountain View, CA 94043-2254 | 2012-06-18 |
| Find all providers in MOUNTAIN VIEW | ||||
| City | MOUNTAIN VIEW |
| Zip Code | 72560 |
Please comment or provide details below to improve the information on BRMC HOMETOWN CLINICS, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.