Individual provider Active NPI

Warren Scott Lafferty, MD

  • Family Medicine Physician
  • Bentonville, AR
National Provider Identifier
1639118391
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-0988 Issued in AR
Practice address
1706 SE Walton Blvd Ste 4
Bentonville, AR 72712-3201
Phone
(479) 464-0400
NPI assigned
Jun 6, 2006
Last updated
Apr 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E-0988 AR
Family Medicine Physician 207Q00000X E-0988 AR Primary

Addresses

Primary practice location

1706 SE Walton Blvd Ste 4
Bentonville, AR 72712-3201

Mailing address

1706 SE Walton Blvd Ste 4
Bentonville, AR 72712-3201
Phone (479) 464-0400

Other practice location 1

114 Harrison Ave
Suite B
Lowell, AR 72745-9047
Phone (479) 770-4343

Other identifiers 1

IdentifierTypeStateIssuer
130105001MedicaidAR

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050428001114 AR Practitioner - Family PracticePractitioner - Emergency Medicine 2264471275 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3333 S Pinnacle Hills Pkwy
Suite 100
Rogers, AR 72758-8953
Phone (479) 464-0400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Arkansas Emergency Physicians, LLP Emergency Medicine CurrentSince May 2, 2017 Accepting new patients
South Arkansas Emergency Physicians, LLP Emergency Medicine CurrentSince May 2, 2017 Accepting new patients
Emergency Medicine of Arkansas PLLC Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
South Arkansas Emergency Physicians LLP Emergency Medicine Current Accepting new patients
Mabelvale Community Emergency Physicians Emergency Medicine Past Accepting new patients
Petit Jean Emergency Physicians Emergency Medicine Past Accepting new patients
Caddoes Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Karas Family Walk-in Clinic Family Medicine Past Accepting new patients
Boston Heart Diagnostics Corporation PastSince May 3, 2020 Accepting new patients

Locations

1706 SE Walton Blvd
Ste 4
Bentonville, AR 72712
Phone (479) 464-0400

3873 N Parkview Dr
Fayetteville, AR 72703
Phone (479) 527-0050

3333 S Pinnacle Hills Pkwy
Ste 100
Rogers, AR 72758
Phone (479) 464-0400

609 W Maple Ave
Springdale, AR 72764
Phone (479) 751-5711

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HHADCD/Endpoint/HHADCD

Organizations & group practices 9

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1639118391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 SE WALTON BLVD STE 4",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123201",
            "telephone_number": "479-464-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 SE WALTON BLVD STE 4",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123201",
            "telephone_number": "479-464-0400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Harrison Ave",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Lowell",
            "state": "AR",
            "postal_code": "727459047",
            "country_code": "US",
            "telephone_number": "479-770-4343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAFFERTY",
        "first_name": "WARREN",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-0988",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-0988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130105001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.