NPIMap

Organization Active NPI

Washington Regional Medical System

  • Specialist
  • Fayetteville, AR
National Provider Identifier
1679552970
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
WASHINGTON REGIONAL MEDICAL SYSTEM
Practice address
3276 N Northhills Blvd
Fayetteville, AR 72703
Phone
(479) 587-1114
Fax
(479) 587-1119
NPI assigned
Jan 13, 2006
Last updated
Apr 3, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
WASHINGTON REGIONAL MEDICAL SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Authorized official

Name
Dan Eckels
Title
Cfo
Phone
(479) 463-2825

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

3276 N Northhills Blvd
Fayetteville, AR 72703

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
100727330AMedicaidOK
506707108MedicaidMO
118256002MedicaidAR

Other names 1

  • Cardiovascular and Thoracic Surgery Washington Regional Other name

National Provider Directory

National Provider Directory
Tax ID family
Washington Reg Specialty C26 organizations share this tax ID, including this one
Part of
Washington Reg Specialty C

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

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

601 W Maple Ave
Ste 707
Springdale, AR 72764
Phone (479) 445-4410

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522713600000",
    "number": "1679552970",
    "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 NORTHHILLS BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-587-1114",
            "fax_number": "479-587-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON REGIONAL MEDICAL SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WASHINGTON REGIONAL MEDICAL SYSTEM",
        "enumeration_date": "2006-01-13",
        "last_updated": "2018-04-03",
        "status": "A",
        "authorized_official_last_name": "ECKELS",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "479-463-2825"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100727330A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506707108",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118256002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardiovascular and Thoracic Surgery Washington Regional",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; 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.