Washington Regional Medical System
Organization Active NPI Maternal & Fetal Medicine Physician · Fayetteville, AR
NPI 1497323554 · NPPES record last updated Jun 15, 2021
Key facts
- NPI
- 1497323554
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Maternal & Fetal Medicine Physician 207VM0101X
- Legal business name
- WASHINGTON REGIONAL MEDICAL SYSTEM
- Practice address
- 3215 N. Northhills Blvd.
Fayetteville, AR 72703 - Phone
- (479) 463-2935
- Fax
- (479) 463-2936
- NPI assigned
- Jun 15, 2021
- Organization subpart
- No
Authorized official
- Name
- Daniel R Eckels
- Title
- Cfo
- Phone
- (479) 463-2825
Other NPIs on the same Medicare enrollment 23
Corporate family (same tax ID) 25
Practitioners 8
-
Jamal Ziad Abdin, M.D.
-
Ashley Brooke Keathley, WHNP-BC
-
Jeffrey D Kellar, M.D.
-
Carolyn Nutter, PA
-
Megan Breanna Sanchez, PA-C
-
James W Gorman, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100130000001 | AR | Part B Supplier - Clinic/Group Practice | 8820995434 |
Receives reassigned benefits from 117 practitioners 23 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Springdale, AR; Fayetteville, AR; Harrison, AR; Lincoln, AR; Lowell, AR; Siloam Springs, AR; Berryville, AR; Bentonville, AZ… |
National Provider Directory
- Tax ID family
- Walker Heart Inst
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Maternal & Fetal Medicine Physician |
207VM0101X | Yes |
Addresses
Primary practice location
3215 N. Northhills Blvd.
Fayetteville, AR 72703
Mailing address
PO Box 550
Lowell, AR 72745
Phone (479) 463-7775
Other names
- Washington Regional Maternal Fetal Medicine Clinic
Other providers in Fayetteville, AR
- Washington Regional Medical System
- Washington Regional Medical System
- Washington Regional Medical System
- Washington Regional Medical System
- Washington Regional Medical System
- Washington Regional Medical System
- Washington Regional Medical System
- Washington Regional Medical System
- Washington Regional Medical System
- Washington Regional Medical System
All providers in Fayetteville, AR · Maternal & Fetal Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.