Washington Regional Medical System

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

WASHINGTON REGIONAL MEDICAL SYSTEM

Doing business as

Washington Regional Diagnostic Clinic

Practice address

3000 NW a St
Bentonville, AR 72712-3985

Phone

(479) 268-3050

Fax

(479) 268-3061

NPI assigned

May 11, 2006

Organization subpart

No

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

Authorized official

Name

Daniel R Eckels

Title

Senior VP/Cfo

Phone

(479) 463-6026

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Washington Regional Diagnostic Clinic Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Washington Regional Medical System

  dba Washington Regional Endocrinology

  • Endocrinology, Diabetes & Metabolism Physician
  • Fayetteville, AR
  • NPI 1255758868

  Member Of

  NPD member

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268179200000",
    "number": "1598715302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 E APPLEBY RD",
            "address_2": "CLINIC ADMINISTRATION",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033901",
            "telephone_number": "479-463-1704",
            "fax_number": "479-463-7864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NW A ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123985",
            "telephone_number": "479-268-3050",
            "fax_number": "479-268-3061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON REGIONAL MEDICAL SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2010-03-10",
        "status": "A",
        "authorized_official_last_name": "ECKELS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SENIOR VP/CFO",
        "authorized_official_telephone_number": "479-463-6026"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135445004",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington Regional Diagnostic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole M Ward, MHPP/TEACHER
• Sarah Ward, MHPP
• Warm Horizons Counseling
• Megan Warner
• Brooke Nicole Warren, PT
• Sandra Waters, RN/MHPP
• Hannah Watkins, LAC
• Kylie Watkins, PLMSW
• J. Benjamin Weakley
• Amanda Morgan Weaver, LAC

• Internal Medicine Physician in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Internal Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; 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.