Individual provider Active NPI

Gary R. Highfill, MD

  • Otolaryngology Physician
  • Fort Smith, AR
National Provider Identifier
1073693909
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
2001014986 Issued in MO
Practice address
1500 Dodson Ave
Ste 260
Fort Smith, AR 72901-5182
Phone
(479) 573-7985
Fax
(479) 573-7987
NPI assigned
Oct 16, 2006
Last updated
Nov 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 2001014986 MO Primary

Addresses

Primary practice location

1500 Dodson Ave
Ste 260
Fort Smith, AR 72901-5182

Mailing address

PO Box 11449
Belfast, ME 04915-4005
Phone (479) 709-1924

Other identifiers 2

IdentifierTypeStateIssuer
148435001MedicaidAR
200171840AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20050524001027 MO Practitioner - Otolaryngology 5496797003 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizens Memorial HealthcareGroup PAC ID 4183528169, 144 clinicians

Practice addresses (Care Compare)

Bolivar, MO 65613
Phone (417) 328-6631

1155 W Parkview
2K CMH Rheumatology
Bolivar, MO 65613-8598
Phone (417) 328-7000

1155 W Parkview St
Suite 2J
Bolivar, MO 65613-8598
Phone (417) 328-7702

1500 N Oakland Ave
CMH Diabetes
Bolivar, MO 65613-3099
Phone (417) 328-6040

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2001014986MOMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Citizens Memorial Healthcare CurrentSince Jan 1, 2025 Accepting new patients
Citizens Memorial Healthcare CurrentSince Jan 1, 2025 Accepting new patients
Midwest Division - LRHC LLC CurrentSince Aug 1, 2023 Accepting new patients
Ozarks Medical Center Otolaryngology Past Accepting new patients

Locations

1155 W Parkview St
Ste 2J
Bolivar, MO 65613
Phone (417) 328-7000

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

1500 State St
Lexington, MO 64067
Phone (660) 259-2203

Organizations & group practices 4

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1073693909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11449",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154005",
            "telephone_number": "479-709-1924",
            "fax_number": "479-709-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DODSON AVE",
            "address_2": "STE 260",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729015182",
            "telephone_number": "479-573-7985",
            "fax_number": "479-573-7987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGHFILL",
        "first_name": "GARY",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "2001014986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148435001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200171840A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.