Organization Active NPI

County of Washington

Doing business as Washington County HIV Clinic

  • Family Medicine Physician
  • Fayetteville, AR
National Provider Identifier
1053476606
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ARC4505 Issued in AR
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, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTY OF WASHINGTONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 23, 2012

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
122854002MedicaidAR

Other names 1

  • Washington County HIV Clinic Doing business as

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.

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.

Verify at the official NPI Registry.