Individual provider Active NPI

Joseph Randall Yates, CRNA

  • Certified Registered Nurse Anesthetist
  • Fayetteville, AR
National Provider Identifier
1386887909
Registry record updated Aug 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R50192 Issued in AR
Practice address
3215 N Northhills Blvd
Fayetteville, AR 72703
Phone
(918) 664-9892
Fax
(918) 664-2521
NPI assigned
Apr 13, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R50192 AR Primary

Addresses

Primary practice location

3215 N Northhills Blvd
Fayetteville, AR 72703

Mailing address

PO Box 1867
Fayetteville, AR 72702-1867
Phone (918) 641-2551

Other identifiers 3

IdentifierTypeStateIssuer
770193801OtherARARKANSAS BREASTCARE
177926001MedicaidAR
200246350AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090624000109 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698826121 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Anesthesia of Arkansas Professional CorporationGroup PAC ID 6406077460, 87 clinicians
Renew Medical Group of Arkansas LTDGroup PAC ID 3173056298, 129 clinicians

Practice addresses (Care Compare)

3215 N N Hills Blvd
Fayetteville, AR 72703-4424
Phone (479) 463-1000

7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone (479) 314-6000

Hospital & facility affiliations

  • Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004
  • Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R50192ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Arkansas Anesthesiology Associates P.a. CurrentSince Jul 1, 2022 Accepting new patients
Western Arkansas Obstetric Anesthesia LLC CurrentSince Jul 1, 2022 Accepting new patients
Premier Anesthesia of Arkansas Professional Corporation Nurse Anesthetist, Certified Registered CurrentSince May 10, 2014 Accepting new patients
Renew Medical Group of Arkansas LTD Nurse Anesthetist, Certified Registered CurrentSince May 15, 2025 Accepting new patients

Locations

3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1000

3215 N Northhills Blvd
Ste B
Fayetteville, AR 72703
Phone (479) 463-1000

6801 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-6000

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533340800000",
    "number": "1386887909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1867",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727021867",
            "telephone_number": "918-641-2551",
            "fax_number": "918-392-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 N NORTHHILLS BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "918-664-9892",
            "fax_number": "918-664-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YATES",
        "first_name": "JOSEPH",
        "middle_name": "RANDALL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-13",
        "last_updated": "2018-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "R50192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BREASTCARE",
            "identifier": "770193801",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177926001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200246350A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 4, 2018; 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.