Individual provider Active NPI

William Tyson Austin, D.C.

  • Chiropractor
  • Rogers, AR
National Provider Identifier
1194003772
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
15926 Issued in AR
Practice address
5204 Village Pkwy
Suite 8
Rogers, AR 72758-8104
Phone
(479) 268-6095
Fax
(479) 268-3497
NPI assigned
Jul 29, 2011
Last updated
Oct 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 15926 AR Primary

Addresses

Primary practice location

5204 Village Pkwy
Suite 8
Rogers, AR 72758-8104

Mailing address

5204 Village Pkwy
Suite 8
Rogers, AR 72758-8104
Phone (479) 268-6095

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111206000192 AR Practitioner - Chiropractic 5294900163 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5204 W Village Pkwy
Suite 8
Rogers, AR 72758-8146
Phone (479) 268-6095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15926ARMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fayetteville Chiropractic, PLLC Chiropractor CurrentSince Jan 15, 2015 Accepting new patients
New Hope Functional Chiropractic PLLC Chiropractor CurrentSince Aug 9, 2011 Accepting new patients

Locations

715 N College Ave
Fayetteville, AR 72701
Phone (479) 442-0352

5204 W Village Pkwy
Ste 8
Rogers, AR 72758
Phone (479) 268-6095

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1194003772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5204 VILLAGE PKWY",
            "address_2": "SUITE 8",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588104",
            "telephone_number": "479-268-6095",
            "fax_number": "479-268-3497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5204 VILLAGE PKWY",
            "address_2": "SUITE 8",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588104",
            "telephone_number": "479-268-6095",
            "fax_number": "479-268-3497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUSTIN",
        "first_name": "WILLIAM",
        "middle_name": "TYSON",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-29",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "15926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.