Charles W Tevebaugh, APN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

A01080 Issued in AR

Practice address

12 E Appleby
Suite 101
Fayetteville, AR 72703

Phone

(479) 463-4444

Fax

(479) 463-4499

NPI assigned

Aug 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Washington Regional Medical SystemGroup PAC ID 8820995434, 238 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ctevebaugh41398@washingtonregional.direct-ci.com

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.

• Washington Regional Medical System

  dba Washington Regional Senior Clinic

  • Multi-Specialty Clinic/Center
  • Fayetteville, AR
  • NPI 1699731208
  Medicare reassignment Care Compare group NPD
• Washington Regional Medical System

  dba Washington Regional Family Clinic - Farmington

  • Family Medicine Physician
  • Farmington, AR
  • NPI 1275839011
  NPD
• Washington Regional Medical Center

  dba Washington Regiona Medical Center Mobile Dental Clinic

  • Dentist
  • Fayetteville, AR
  • NPI 1669877668
  NPD (past)

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

• Washington Regional Medical Center

  • General Acute Care Hospital
  • Fayetteville, AR
  • NPI 1083609150
  Care Compare affiliation

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303430400000",
    "number": "1316959216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 E APPLEBY",
            "address_2": "SUITE 101",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-463-4444",
            "fax_number": "479-463-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 E APPLEBY",
            "address_2": "SUITE 101",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-463-4444",
            "fax_number": "479-463-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEVEBAUGH",
        "first_name": "CHARLES",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2011-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AR",
            "license": "A01080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Leigh Terry, APN
• Julian Anthony Terry Sr., M.D.
• Philip Jon Terry, M.D.
• Trenton Zachary Terry, PHARMD
• Eleni A. Tesch
• Texarkana Behavioral Associates LC
• Texarkana Behavioral Associates LC (Vista Health)
• Texarkana Behavioral Associates, L.C. (Vantage Point of Northwest Arkansas)
• Texarkana Behavioral Associates, L.C. (Vantage Point of Northwest Arkansas)
• Texarkana Behavioral Associates, L.C. (Vantage Point of Northwest Arkansas)

• Gerontology Nurse Practitioner in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Gerontology Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.