Active NPI
County of Washington
Doing business as Washington County HIV Clinic
- Family Medicine Physician
- Fayetteville, AR
National Provider Identifier
1053476606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ARC4505
- Legal business name
- COUNTY OF WASHINGTON
- Doing business as
- Washington County HIV Clinic
- Practice address
- 3270 N. Wimberly Drive
Fayetteville, AR 72703 - Phone
- (479) 973-8450
- Fax
- (479) 973-8452
- NPI assigned
- Dec 26, 2006
- Last updated
- May 23, 2012
- Organization subpart
- Yes
- Parent organization
- COUNTY OF WASHINGTON
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Linda McGhee, M.D.
- Title
- Medical Director
- Phone
- (479) 973-8450
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ARC4505 | AR | Primary |
Addresses
Primary practice location
3270 N. Wimberly Drive
Fayetteville, AR 72703
Mailing address
3270 N. Wimberly Drive
Fayetteville, AR 72703
Phone (479) 973-8450
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 122854002 | Medicaid | AR |
Other names 1
- Washington County HIV Clinic
National Provider Directory
National Provider Directory- Part of
- County of Washington
Member organizations 1
Organizations listed as members of this organization in the National Provider Directory.
-
dba Central EMS
- Ambulance
- Fayetteville, AR
- NPI 1972767630
Member Of
Locations
3270 N Wimberly Dr
Fayetteville, AR 72703
Phone (479) 521-8181
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1337731200000",
"number": "1053476606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3270 N. WIMBERLY DRIVE",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "72703",
"telephone_number": "479-973-8450",
"fax_number": "479-973-8452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3270 N. WIMBERLY DRIVE",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "72703",
"telephone_number": "479-973-8450",
"fax_number": "479-973-8452"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COUNTY OF WASHINGTON",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "COUNTY OF WASHINGTON",
"enumeration_date": "2006-12-26",
"last_updated": "2012-05-23",
"status": "A",
"authorized_official_last_name": "MCGHEE",
"authorized_official_first_name": "LINDA",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "479-973-8450",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "AR",
"license": "ARC4505",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "122854002",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Washington County HIV Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.