WHITE RIVER HEALTH FAMILY MEDICINE
NPI 1104642354
Clinic/Center - Multi-Specialty in Cherokee Village, AR
About White River Health Family Medicine NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WHITE RIVER HEALTH FAMILY MEDICINE (NPI 1104642354) is a healthcare organization registered as a multi-specialty in Cherokee Village, Arkansas and active in the NPI registry since December 2024. The organization holds a CLIA Waiver certificate valid through December 16, 2027 and lists Shawna Baxter, Provider Enrollment Specialist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
White River Health Family Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
28Medicare enrollment records show 28 clinicians reassign Medicare billing to White River Health Family Medicine, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 4 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 3
Nearest to this location (20)
See all 28Melbourne, AR 72556
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 04D0941101
White River Health Family Medicine · Cherokee Village, ARFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is White River Health System, Inc.'s NPI number?
The NPI number for White River Health System, Inc. is 1104642354. It was assigned to this organization in the NPPES registry on December 3, 2024. The provider is doing business as White River Health Family Medicine.
Where is White River Health System, Inc. located?
White River Health System, Inc. is located at 197 Hospital Dr Ste B, Cherokee Village, AR 72529. The listed phone number is (870) 257-5118.
What is White River Health System, Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is White River Health System, Inc. enrolled in Medicare?
Yes. White River Health System, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through White River Health System, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 28 clinicians in 3 Medicare specialties reassign their Medicare billing to White River Health System, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (26), Family Practice (1) and General Practice (1). Of these, 1 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does White River Health System, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 04D0941101) is associated with this NPI, valid through December 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does White River Health System, Inc. accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list White River Health System, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for White River Health System, Inc. was last updated on December 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# White River Health Family Medicine · NPI 1104642354
Multi-Specialty organization in Cherokee Village, Arkansas. Organization record, active in the CMS NPPES registry since December 3, 2024.
## Identity
- **NPI:** 1104642354 (Entity type: Organization)
- **Enumerated:** December 3, 2024
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Legal business name:** White River Health System, Inc.
- **Organization subpart:** No
- **Authorized official:** Shawna Baxter, PROVIDER ENROLLMENT SPECIALIST
## Practice location
- **Address:** 197 HOSPITAL DR STE B, Cherokee Village, AR 72529-7315
- **Phone:** (870) 257-5118 · **Fax:** (870) 257-6215
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 28 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (26), Family Practice (1), General Practice (1); 1 practice at this address and 4 within 10 miles; [full list](https://npiprofile.com/npi/1104642354/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 3, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1104642354) · Data from the CMS NPPES public registry.