NPIMap

Organization Active NPI

Washington Regional Medical System

Doing business as Washington Regional Neonatology

  • Neonatal-Perinatal Medicine Physician
  • Fayetteville, AR
National Provider Identifier
1346294154
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
Legal business name
WASHINGTON REGIONAL MEDICAL SYSTEM
Doing business as
Washington Regional Neonatology
Practice address
3215 N North Hills Blvd
Fayetteville, AR 72703
Phone
(479) 463-1000
NPI assigned
May 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mary Jo Rothrock
Title
Director Clinic Administration
Phone
(479) 463-1390

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080N0001X Primary

Addresses

Primary practice location

3215 N North Hills Blvd
Fayetteville, AR 72703

Mailing address

PO Box 879
Fayetteville, AR 72702-0879
Phone (479) 713-7115

Other names 1

  • Washington Regional Neonatology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Nwa Clinic for Women26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346294154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 879",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727020879",
            "telephone_number": "479-713-7115",
            "fax_number": "479-713-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 N NORTH HILLS BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-463-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON REGIONAL MEDICAL SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROTHROCK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "DIRECTOR CLINIC ADMINISTRATION",
        "authorized_official_telephone_number": "479-463-1390"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington Regional Neonatology",
            "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 Aug 22, 2020; 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.