Individual provider Active NPI

Richard Allen Wyatt Jr., MD

  • Anesthesiology Physician
  • Rogers, AR
National Provider Identifier
1679034698
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
E-16452 Issued in AR
Practice address
378 S Pinnacle Hills Pkwy
Ste 100
Rogers, AR 72758
Phone
(479) 757-4772
NPI assigned
Mar 31, 2019
Last updated
May 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X E-16452 AR Primary

Addresses

Primary practice location

378 S Pinnacle Hills Pkwy
Ste 100
Rogers, AR 72758

Mailing address

409 Cascade LN
Cave Springs, AR 72718-9430
Phone (501) 658-0123

Other practice location 1

4301 W Markham St # 515
Little Rock, AR 72205-7101
Phone (501) 603-1656

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
I20230725001728 AR Practitioner - Anesthesiology 3375877954 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Anesthesia of Arkansas Professional CorporationGroup PAC ID 6406077460, 87 clinicians

Practice addresses (Care Compare)

3215 N N Hills Blvd
Fayetteville, AR 72703-4424
Phone (479) 463-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-16452ARMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Anesthesia Solutions of Arkansas, LLC Anesthesiology CurrentSince Jul 12, 2023 Accepting new patients
Arkansas Health Group Anesthesiology CurrentSince Jul 1, 2023 Accepting new patients
Ans Services of Arkansas PA Anesthesiology CurrentSince Dec 23, 2023 Accepting new patients
Premier Anesthesia of Arkansas Professional Corporation Anesthesiology CurrentSince May 4, 2025 Accepting new patients
Arkansas Health Group CurrentSince Jul 1, 2023 Accepting new patients

Locations

3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1000

1001 Towson Ave
Fort Smith, AR 72901
Phone (479) 441-3980

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

603 N Progress Ave
Siloam Springs, AR 72761
Phone (479) 215-3000

2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804

Interoperability endpoints

  • Direct secure messaging: rwyatt48845@washingtonregional.direct-ci.com

Organizations & group practices 5

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": "1553990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1679034698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 CASCADE LN",
            "city": "CAVE SPRINGS",
            "state": "AR",
            "postal_code": "727189430",
            "telephone_number": "501-658-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 S PINNACLE HILLS PKWY",
            "address_2": "STE 100",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "72758",
            "telephone_number": "479-757-4772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St # 515",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-603-1656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYATT",
        "first_name": "RICHARD",
        "middle_name": "ALLEN",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-31",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E-16452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.