NPIMap

Organization Active NPI

Washington Regional Medical System

Doing business as Walker Heart Institute Cardiovascular Clinic

  • Interventional Cardiology Physician
  • Fayetteville, AR
National Provider Identifier
1679890966
Registry record updated Apr 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
WASHINGTON REGIONAL MEDICAL SYSTEM
Doing business as
Walker Heart Institute Cardiovascular Clinic
Practice address
3211 N Northhills Blvd
Suite 110
Fayetteville, AR 72703-4007
Phone
(479) 571-4338
Fax
(479) 571-4015
NPI assigned
Apr 26, 2010
Last updated
Apr 26, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2010

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

Authorized official

Name
Daniel R Eckels
Title
Senior VP/Cfo
Phone
(479) 463-6026

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X NU Primary

Addresses

Primary practice location

3211 N Northhills Blvd
Suite 110
Fayetteville, AR 72703-4007

Mailing address

12 E Appleby Rd
Clinic Administration
Fayetteville, AR 72703-3901
Phone (479) 463-1704

Other names 1

  • Walker Heart Institute Cardiovascular Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100812000027 AR Part B Supplier - Clinic/Group Practice 8820995434 Receives reassigned benefits from 36 practitioners
Practice locations: Fayetteville, AR

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

3215 N Northhills Blvd
Ste 110
Fayetteville, AR 72703

1675 W Jefferson St
Ste C
Siloam Springs, AR 72761
Phone (479) 215-3060

813 Founders Park Dr E
Ste 105
Springdale, AR 72762

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Encompass Health Rehabilitation Hospital, a Partner of Washington RegiFayetteville, AR, CCN 043032 Hospital 5% Or Greater Indirect Ownership Interest (50%) Dec 31, 2007

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272240000000",
    "number": "1679890966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 E APPLEBY RD",
            "address_2": "CLINIC ADMINISTRATION",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033901",
            "telephone_number": "479-463-1704",
            "fax_number": "479-463-7864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 N NORTHHILLS BLVD",
            "address_2": "SUITE 110",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034007",
            "telephone_number": "479-571-4338",
            "fax_number": "479-571-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON REGIONAL MEDICAL SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-26",
        "last_updated": "2010-04-26",
        "status": "A",
        "authorized_official_last_name": "ECKELS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SENIOR VP/CFO",
        "authorized_official_telephone_number": "479-463-6026"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walker Heart Institute Cardiovascular Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.