Active NPI
Richard Lynn McDougal, MD
- Ophthalmology Physician
- Clarksville, AR
National Provider Identifier
1427049097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- C5294
- Practice address
- 709 W Main St
Clarksville, AR 72830-3410 - Phone
- (479) 754-6303
- Fax
- (479) 754-5599
- NPI assigned
- Nov 2, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | C5294 | AR | Primary |
Addresses
Primary practice location
709 W Main St
Clarksville, AR 72830-3410
Mailing address
PO Box 270
709 W Main
Clarksville, AR 72830-0270
Phone (479) 754-6303
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103104001 | Medicaid | AR |
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090406000067 | AR | Practitioner - Ophthalmology | 0648327874 | Practice locations: Clarksville, AR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C5294 | AR | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331164800000",
"number": "1427049097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 270",
"address_2": "709 W MAIN",
"city": "CLARKSVILLE",
"state": "AR",
"postal_code": "728300270",
"telephone_number": "479-754-6303",
"fax_number": "479-754-5599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 W MAIN ST",
"city": "CLARKSVILLE",
"state": "AR",
"postal_code": "728303410",
"telephone_number": "479-754-6303",
"fax_number": "479-754-5599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDOUGAL",
"first_name": "RICHARD",
"middle_name": "LYNN",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-02",
"last_updated": "2012-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "AR",
"license": "C5294",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103104001",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.