NPIMap

Organization Active NPI

Ambulatory Anesthesia Associates PLLC

  • Anesthesiology Physician
  • Fayetteville, AR
National Provider Identifier
1497086292
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
AMBULATORY ANESTHESIA ASSOCIATES PLLC
Practice address
3271 N Wimberly Dr
Fayetteville, AR 72703-4033
Phone
(660) 826-5960
NPI assigned
Jan 19, 2010
Last updated
Feb 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Authorized official

Name
Rebecca McChristian
Title
Office Manager
Phone
(660) 826-5960

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

3271 N Wimberly Dr
Fayetteville, AR 72703-4033

Mailing address

PO Box 1547
Sedalia, MO 65302-1547
Phone (660) 826-5960

Other identifiers 2

IdentifierTypeStateIssuer
181027002MedicaidAR
5G234OtherARBCBS GROUP NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100304000035 AR Part B Supplier - Clinic/Group Practice 4880739648 Receives reassigned benefits from 15 practitioners
Practice locations: Fayetteville, AR

National Provider Directory

National Provider Directory

Locations

3271 N Wimberly Dr
Fayetteville, AR 72703
Phone (479) 713-6000

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1263859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582243200000",
    "number": "1497086292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1547",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653021547",
            "telephone_number": "660-826-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3271 N WIMBERLY DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034033",
            "telephone_number": "660-826-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBULATORY ANESTHESIA ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-19",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A",
        "authorized_official_last_name": "MCCHRISTIAN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "660-826-5960"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181027002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "5G234",
            "state": "AR"
        }
    ],
    "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 Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.