Covered Entity Details

DSH040014X WHITE COUNTY MEDICAL CENTER (Active) - information as of 4/29/2025 11:49:44 PM

Main Details

Name

WHITE COUNTY MEDICAL CENTER

Subdivision Name

UH Newport Family Practice

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH040014X

Medicare Provider Number

040014

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

2/25/2016

Participating Start Date

4/1/2016

Participating Approval Date

3/2/2016

Last Recertification Date

9/6/2024

Contacts

Authorizing Official

White County Medical Center
Stuart Randall Hill, VP Treasurer
(501) 380-1004

Primary Contact

White County Medical Center
Scotty Terl Parker, AVP Ancillary Services
(501) 380-1382

Addresses

Street Address

1200 McLain Street, Suite B & D
Newport, AR 72112

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
AR	279479002	1093475469

Shipping Addresses

Shipping Address 1

Unity Health - Newport Rx
1205 McLain Street
Newport, AR 72112

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH040014AA	Child	DSH	WHITE COUNTY MEDICAL CENTER	UH Medical Clinic Heber Springs	2725 AR-25 Bypass	Heber Springs	AR	Active
DSH040014AB	Child	DSH	WHITE COUNTY MEDICAL CENTER	Harris Medical Center / Acute Care Hospital - Operating Room	1205 McLain Street	Newport	AR	Terminated
DSH040014AC	Child	DSH	WHITE COUNTY MEDICAL CENTER	Harris Medical Center / Acute Care Hospital - Anesthesiology	1205 McLain Street	Newport	AR	Terminated
DSH040014AD	Child	DSH	WHITE COUNTY MEDICAL CENTER	Harris Medical Center / Acute Care Hospital - Radiology	1205 McLain Street	Newport	AR	Terminated
DSH040014AE	Child	DSH	WHITE COUNTY MEDICAL CENTER	Harris Medical Center / Acute Care Hospital - Lab	1205 McLain Street	Newport	AR	Terminated
DSH040014AF	Child	DSH	WHITE COUNTY MEDICAL CENTER	Harris Medical Center / Acute Care Hospital - Respiratory Therapy	1205 McLain Street	Newport	AR	Terminated
DSH040014AG	Child	DSH	WHITE COUNTY MEDICAL CENTER	Harris Medical Center / Acute Care Hospital - Physical Therapy	1205 McLain Street	Newport	AR	Terminated
DSH040014AH	Child	DSH	WHITE COUNTY MEDICAL CENTER	Harris Medical Center / Acute Care Hospital - Emergency Room	1205 McLain Street	Newport	AR	Terminated
DSH040014AJ	Child	DSH	WHITE COUNTY MEDICAL CENTER	Harris Medical Center / Acute Care Hospital - Adults and Peds	1205 McLain Street	Newport	AR	Terminated
DSH040014AK	Child	DSH	WHITE COUNTY MEDICAL CENTER	Searcy Medical Center - West / Gen Medicine	2505 West Beebe Capps Expressway, Suite 100	Searcy	AR	Active
DSH040014AL	Child	DSH	WHITE COUNTY MEDICAL CENTER	Searcy Medical Center - West Pediatric Clinic / Pediatrics	2505 West Beebe Capps Expy	Searcy	AR	Active
DSH040014AM	Child	DSH	WHITE COUNTY MEDICAL CENTER	UNITY HEALTH BRADFORD MEDICAL CLINIC	504 W MAIN St - Suite A	BRADFORD	AR	Active
DSH040014AN	Child	DSH	WHITE COUNTY MEDICAL CENTER	Rheumatology - Rheumatology	2902 East Race Avenue	Searcy	AR	Active
DSH040014AP	Child	DSH	WHITE COUNTY MEDICAL CENTER	UNITY HEALTH NEWPORT PEDIATRICS CLI - UH Newport Pediatrics Clinic	1200 MCLAIN ST	NEWPORT	AR	Terminated
DSH040014AQ	Child	DSH	WHITE COUNTY MEDICAL CENTER	Unity Health - Neurology - Neurology	2902 East Race Avenue	Searcy	AR	Approved
DSH040014AR	Child	DSH	WHITE COUNTY MEDICAL CENTER	Surgery Center - White County Surgery Center	710 Marion Street - Suite 101	Searcy	AR	Approved
DSH040014AS	Child	DSH	WHITE COUNTY MEDICAL CENTER	Radiology - Unity Health Radiology West	2505 West Beebe Capps Expressway	Searcy	AR	Approved
DSH040014B	Child	DSH	WHITE COUNTY MEDICAL CENTER	WHITE COUNTY ONCOLOGY	415 Rodgers Drive Suite A	SEARCY	AR	Active
DSH040014E	Child	DSH	WHITE COUNTY MEDICAL CENTER	FAMILY PRACTICE ASSOCIATES / Family Medicine	3130 E RACE AVE 100	Searcy	AR	Active
DSH040014F	Child	DSH	WHITE COUNTY MEDICAL CENTER	Westside Family Med Clinic / Family Medicine	103 WOODLANE DR	SEARCY	AR	Terminated
DSH040014G	Child	DSH	WHITE COUNTY MEDICAL CENTER	Cardiology Clinic	711 SANTA FE DR	SEARCY	AR	Active
DSH040014H	Child	DSH	WHITE COUNTY MEDICAL CENTER	ORTHOPEDIC & SPINE CENTER PHYSICAL / Multispeciality	710 MARION ST	SEARCY	AR	Active
DSH040014J	Child	DSH	WHITE COUNTY MEDICAL CENTER	SEARCY MEDICAL CENTER / Multispeciality (Family Med, Internal Med, Ortho etc.)	2900 HAWKINS DR	SEARCY	AR	Active
DSH040014K	Child	DSH	WHITE COUNTY MEDICAL CENTER	MCAFEE MEDICAL CLINIC	710-A West Dewitt Henry Drive	BEEBE	AR	Active
DSH040014L	Child	DSH	WHITE COUNTY MEDICAL CENTER	McAfee Urgent Care	2900 Hawkins Drive	Searcy	AR	Terminated
DSH040014M	Child	DSH	WHITE COUNTY MEDICAL CENTER	CLARITY HEALTH AND WELLNESS	2908 HAWKINS DR	SEARCY	AR	Active
DSH040014N	Child	DSH	WHITE COUNTY MEDICAL CENTER	Harris Medical Clinic	1200 McLain Street, Suite B	Newport	AR	Terminated
DSH040014P	Child	DSH	WHITE COUNTY MEDICAL CENTER	Harris Family Practice Clinic	1200 McLain Street	Newport	AR	Terminated
DSH040014Q	Child	DSH	WHITE COUNTY MEDICAL CENTER	UH Green Family Practice Clinic	1200 McLain Street. Suite G	Newport	AR	Active
DSH040014R	Child	DSH	WHITE COUNTY MEDICAL CENTER	UH Newport OB/GYN Clinic	1201 McLain Street	Newport	AR	Active
DSH040014S	Child	DSH	WHITE COUNTY MEDICAL CENTER	Harris Podiatry Clinic	1117 McLain Street, Suite 500	Newport	AR	Terminated
DSH040014T	Child	DSH	WHITE COUNTY MEDICAL CENTER	Harris Orthopedic Clinic	1117 McLain Street	Newport	AR	Terminated
DSH040014U	Child	DSH	WHITE COUNTY MEDICAL CENTER	Harris Surgical Clinic	1117 McLain Street, Suite 300	Newport	AR	Terminated
DSH040014V	Child	DSH	WHITE COUNTY MEDICAL CENTER	Harris Pediatric Clinic	2000 McLain Street, Suite B	Newport	AR	Terminated
DSH040014W	Child	DSH	WHITE COUNTY MEDICAL CENTER	Harris Internal Med Clinic	2000 McLain Street	Newport	AR	Terminated
DSH040014X	Child	DSH	WHITE COUNTY MEDICAL CENTER	UH Newport Family Practice	1200 McLain Street, Suite B & D	Newport	AR	Active
DSH040014Y	Child	DSH	WHITE COUNTY MEDICAL CENTER	Newport Cardiology Clinic	2000 McLain Street	Newport	AR	Terminated
DSH040014Z	Child	DSH	WHITE COUNTY MEDICAL CENTER	Newport Pediatric Clinic	2000 McLain Street	Newport	AR	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Shipping Address	Update	Change Request	Unity Health - Newport Rx 1205 McClain Street Newport, AR 72112	Unity Health - Newport Rx 1205 McLain Street Newport, AR 72112	2/18/2025 8:21 AM
Addresses	Main Address	Update	Change Request	1200 McClain Street, Suite B & D Newport, AR 72112	1200 McLain Street, Suite B & D Newport, AR 72112	2/18/2025 8:21 AM
Details	Last Recertification Date	Update	Recertification	9/11/2023 1:26:35 PM	9/6/2024 1:55:38 PM	9/6/2024 1:55 PM
Addresses	Main Address	Update	Recertification	1200 McClain Street, Suite B Newport, AR 72112	1200 McClain Street, Suite B & D Newport, AR 72112	9/11/2023 1:26 PM
Details	Last Recertification Date	Update	Recertification	9/15/2022 4:05:22 PM	9/11/2023 1:26:35 PM	9/11/2023 1:26 PM
Addresses	Shipping Address	Insert	Change Request		Unity Health - Newport Rx 1205 McClain Street Newport, AR 72112	6/20/2023 7:43 AM
Addresses	Main Address	Update	Change Request	1200 McLain Street Suite B Newport, AR 72112	1200 McClain Street, Suite B Newport, AR 72112	6/20/2023 7:43 AM
Details	Entity Subname	Update	Change Request	Newport Primary Care Clinic	UH Newport Family Practice	4/24/2023 7:33 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/15/2022 4:05 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		279479002	9/15/2022 4:05 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		AR	9/15/2022 4:05 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	208927002 (AR)		9/15/2022 4:05 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1720476005 (AR)		9/15/2022 4:05 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1093475469	9/15/2022 4:05 PM
Medicaid Billing	NPI: State	Insert	Recertification		AR	9/15/2022 4:05 PM
Details	Last Recertification Date	Update	Recertification	9/13/2021 1:05:20 PM	9/15/2022 4:05:22 PM	9/15/2022 4:05 PM
Details	Last Recertification Date	Update	Recertification	9/14/2020 1:54:12 PM	9/13/2021 1:05:20 PM	9/13/2021 1:05 PM
Addresses	Main Address	Update	Recertification	2000 McLain Street Newport, AR 72112	1200 McLain Street Suite B Newport, AR 72112	9/14/2020 1:54 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1720476005	9/14/2020 1:54 PM
Medicaid Billing	NPI: State	Insert	Recertification		AR	9/14/2020 1:54 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1720476005 ( )		9/14/2020 1:54 PM
Details	Last Recertification Date	Update	Recertification	9/9/2019 1:45:49 PM	9/14/2020 1:54:12 PM	9/14/2020 1:54 PM
Details	Last Recertification Date	Update	Recertification	8/17/2018 4:28:44 PM	9/9/2019 1:45:49 PM	9/9/2019 1:45 PM
Details	Last Recertification Date	Update	Recertification	11/6/2017 3:16:35 PM	8/17/2018 4:28:44 PM	8/17/2018 4:28 PM
Contacts	Authorizing Official	Insert	Change Request		Hill, Stuart Randall VP Treasurer White County Medical Center 5013801004	11/22/2017 7:49 AM
Contacts	Primary Contact	Insert	Recertification		Parker, Scotty Terl AVP Ancillary Services White County Medical Center 5013801382	11/6/2017 3:16 PM
Details	Last Recertification Date	Update	Recertification	9/1/2016 12:00:00 AM	11/6/2017 3:16:35 PM	11/6/2017 3:16 PM
Contacts	Signed By	Update		HILL, STUART VP/CFO 5013801004	HILL, STUART VP/CFO White County Medical Center 5013801004	10/6/2017 3:50 PM
Contacts	Signed By	Insert			HILL, STUART VP/CFO 5013801004	7/13/2017 11:41 AM
Addresses	Main Address	Insert			2000 McLain Street Newport, AR 72112	5/3/2017 11:48 AM
Details	Last Recertification Date	Update			9/1/2016 12:00:00 AM	9/1/2016 4:57 PM
Dates	Participating Approval Date	Update			3/2/2016 12:00:00 AM	3/2/2016 5:33 PM
Details	State	Update		Pending	Active	3/2/2016 5:33 PM
Dates	Start Date	Update			4/1/2016 12:00:00 AM	3/2/2016 5:33 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_58605	DSH040014X	2/26/2016 8:28 AM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_58605	2/25/2016 5:19 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	2/25/2016 5:19 PM
Medicaid Billing	Medicaid: Number	Insert			208927002	2/25/2016 5:19 PM
Medicaid Billing	Medicaid: State	Insert			AR	2/25/2016 5:19 PM
Medicaid Billing	NPI: Number	Insert			1720476005	2/25/2016 5:19 PM
Details	Last Recertification Date	Insert				2/25/2016 5:19 PM
Details	Grant Number	Insert				2/25/2016 5:19 PM
Details	340B ID	Insert				2/25/2016 5:19 PM
Details	Is Authorizing Official EHB Data	Insert				2/25/2016 5:19 PM
Dates	Last Date That 340B Drugs Purchased	Insert				2/25/2016 5:19 PM
Details	Medicare Provider Number	Insert			040014	2/25/2016 5:19 PM
Details	Entity Name	Insert			WHITE COUNTY MEDICAL CENTER	2/25/2016 5:19 PM
Details	Program Code	Insert			DSH	2/25/2016 5:19 PM
Details	Entity Subname	Insert			Newport Primary Care Clinic	2/25/2016 5:19 PM
Dates	Participating Approval Date	Insert				2/25/2016 5:19 PM
Details	State	Insert			Pending	2/25/2016 5:19 PM
Dates	Registration Date	Insert			2/25/2016 12:00:00 AM	2/25/2016 5:19 PM
Dates	Signed By Date	Insert			2/25/2016 12:00:00 AM	2/25/2016 5:19 PM
Dates	Start Date	Insert				2/25/2016 5:19 PM
Terminations	Termination Comments	Insert				2/25/2016 5:19 PM
Terminations	Termination Date	Insert				2/25/2016 5:19 PM
Terminations	Termination Effective Date	Insert				2/25/2016 5:19 PM
Terminations	Termination Reason	Insert				2/25/2016 5:19 PM