Individual provider Active NPI

Mohsen Keyashian, MD

  • Internal Medicine Physician
  • Fort Smith, AR
National Provider Identifier
1629094826
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R-4520 Issued in AR
Practice address
6801 Rogers Ave
Fort Smith, AR 72903-4067
Phone
(479) 274-4100
Fax
(479) 274-4199
NPI assigned
Jul 14, 2006
Last updated
Aug 28, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R-4520 AR Primary

Addresses

Primary practice location

6801 Rogers Ave
Fort Smith, AR 72903-4067

Mailing address

PO Box 3528
Fort Smith, AR 72913-3528
Phone (479) 274-2000

Other identifiers 2

IdentifierTypeStateIssuer
123894001MedicaidAR
110070328OtherRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R-4520ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Clinic, PA 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1629094826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3528",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729133528",
            "telephone_number": "479-274-2000",
            "fax_number": "479-274-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034067",
            "telephone_number": "479-274-4100",
            "fax_number": "479-274-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYASHIAN",
        "first_name": "MOHSEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "R-4520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123894001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110070328",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; 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.