Individual provider Active NPI

Rhagen Lynne Thomas, PA-C

  • Physician Assistant
  • Fayetteville, AR
National Provider Identifier
1194953141
Registry record updated Dec 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-391 Issued in AR
Practice address
3276 N. North Hills Blvd
Fayetteville, AR 72703
Phone
(479) 587-1114
Fax
(479) 587-1119
NPI assigned
Jun 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA-391 AR Primary

Addresses

Primary practice location

3276 N. North Hills Blvd
Fayetteville, AR 72703

Mailing address

PO Box 550
Lowell, AR 72745-0550
Phone (479) 463-7775

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091002000056 AR Practitioner - Physician Assistant 5294871463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
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)

813 Founders Park Dr E
Suite 101
Springdale, AR 72762-6321
Phone (479) 463-2333

Hospital & facility affiliations

  • Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-391ARMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Regional Medical System CurrentSince May 30, 2018 Accepting new patients
Washington Regional Medical System CurrentSince May 30, 2018 Accepting new patients

Locations

3276 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 442-7030

114 E Sunbridge Dr
Fayetteville, AR 72703
Phone (479) 463-2597

Interoperability endpoints

  • Direct secure messaging: rthomas41446@washingtonregional.direct-ci.com

Organizations & group practices 3

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.

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": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608336000000",
    "number": "1194953141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450550",
            "telephone_number": "479-463-7775",
            "fax_number": "479-463-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3276 N. NORTH HILLS BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-587-1114",
            "fax_number": "479-587-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "RHAGEN",
        "middle_name": "LYNNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-29",
        "last_updated": "2020-12-19",
        "certification_date": "2020-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.