NPIMap

Individual provider Active NPI

Robert C. Jaggers, M.D.

  • Specialist
  • Fayetteville, AR
National Provider Identifier
1639165608
Registry record updated Mar 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
R3835 Issued in AR
Practice address
3276 N. North Hills Blvd.
Fayetteville, AR 72703
Phone
(479) 587-1114
Fax
(479) 587-1119
NPI assigned
Sep 23, 2005
Last updated
Mar 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X R3835 AR Primary

Addresses

Primary practice location

3276 N. North Hills Blvd.
Fayetteville, AR 72703

Mailing address

PO Box 550
Lowell, AR 72745-0550
Phone (479) 463-7775

Other identifiers 1

IdentifierTypeStateIssuer
114669001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060109000371 AR Practitioner - Thoracic SurgeryPractitioner - Cardiac SurgeryPractitioner - Vascular Surgery 9436053246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: Cardiac Surgery, Vascular Surgery
Education
University of Texas Medical School at Houston, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

813 Founders Park Dr E
Suite 101
Springdale, AR 72762-6321
Phone (479) 463-2333

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R3835ARMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Regional Medical System CurrentSince May 1, 2018 Accepting new patients
Washington Regional Medical System Current Accepting new patients
Washington Regional Medical System CurrentSince May 1, 2018 Accepting new patients
Washington Regional Medical Center Past Accepting new patients
Western Arkansas Heart Lung & Vascular Surgical Associates Specialist PastSince May 1, 2001 Accepting new patients
Washington Regional Medical System Past Accepting new patients
Arkansas Center for Ear Nose Throat & Allergy PA Past Accepting new patients

Locations

3276 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 442-7030

Interoperability endpoints

  • Direct secure messaging: rjaggers21959@washingtonregional.direct-ci.com

Organizations & group practices 7

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 1

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520553600000",
    "number": "1639165608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450550",
            "telephone_number": "479-463-7775",
            "fax_number": "479-463-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3276 N. NORTH HILLS BLVD.",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-587-1114",
            "fax_number": "479-587-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGGERS",
        "first_name": "ROBERT",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2018-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AR",
            "license": "R3835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114669001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.