David A Churchill

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

C6809 Issued in AR

Practice address

3211 N Northhills Blvd
Suite 110
Fayetteville, AR 72703-4007

Phone

(479) 571-4338

Fax

(479) 571-4015

NPI assigned

Apr 17, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Cardiovascular Disease (Cardiology)

Education

University of Arkansas College of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Washington Regional Medical SystemGroup PAC ID 8820995434, 238 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004
• North Arkansas Regional Medical Center Hospital, Harrison, AR, CCN 040017
• Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dchurchill21346@washingtonregional.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Washington Regional Medical System

  • Interventional Cardiology Physician
  • Fayetteville, AR
  • NPI 1679890966
  Medicare reassignment Care Compare group NPD
• Washington Regional Medical System

  • Family Medicine Physician
  • Farmington, AR
  • NPI 1275839011
  NPD
• Northwest Arkansas Heart & Vascular Center

  • Interventional Cardiology Physician
  • Fayetteville, AR
  • NPI 1982648663
  NPD (past)
• Washington Regional Medical Center

  • Dentist
  • Fayetteville, AR
  • NPI 1669877668
  NPD (past)
• Washington Regional Medical System

  • Hospitalist Physician
  • Fayetteville, AR
  • NPI 1306801485
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Rogers

  • General Acute Care Hospital
  • Rogers, AR
  • NPI 1316902414
  Care Compare affiliation
• North Arkansas Regional Medical Center

  • Land Ambulance
  • Harrison, AR
  • NPI 1013907682

  Hospital

  Care Compare affiliation
• North Arkansas Regional Medical Center

  • General Acute Care Hospital
  • Harrison, AR
  • NPI 1275523912
  Care Compare affiliation
• Washington Regional Medical Center

  • General Acute Care Hospital
  • Fayetteville, AR
  • NPI 1083609150
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1023072808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 N NORTHHILLS BLVD",
            "address_2": "SUITE 110",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034007",
            "telephone_number": "479-571-4338",
            "fax_number": "479-571-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 N NORTHHILLS BLVD",
            "address_2": "SUITE 110",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034007",
            "telephone_number": "479-571-4338",
            "fax_number": "479-571-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCHILL",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AR",
            "license": "C6809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1670494",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "122050000",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111127001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4567131",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "C6809",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100077630A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204813000",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "A023",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Interventional Cardiology Physician in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Interventional Cardiology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.