NPIMap

Organization Active NPI

Washington Regional Medical System

Doing business as Crossroads Medical Clinic - Washington Regional

  • Family Medicine Physician
  • Harrison, AR
National Provider Identifier
1699023895
Registry record updated Aug 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WASHINGTON REGIONAL MEDICAL SYSTEM
Doing business as
Crossroads Medical Clinic - Washington Regional
Practice address
1420 Highway 62 65 N
Harrison, AR 72601-1959
Phone
(870) 741-3600
Fax
(870) 741-6800
NPI assigned
Aug 17, 2012
Last updated
Aug 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2012

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

Authorized official

Name
Michael D Cash
Title
Director of Clinic Operations
Phone
(479) 463-1390

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
Obstetrics & Gynecology Physician 207V00000X

Addresses

Primary practice location

1420 Highway 62 65 N
Harrison, AR 72601-1959

Mailing address

1420 Highway 62 65 N
Harrison, AR 72601-1959
Phone (870) 741-3600

Other names 1

  • Crossroads Medical Clinic - Washington Regional Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100130000001 AR Part B Supplier - Clinic/Group Practice 8820995434 Receives reassigned benefits from 117 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Springdale, AR; Fayetteville, AR; Harrison, AR; Lincoln, AR; Lowell, AR; Siloam Springs, AR; Berryville, AR; Bentonville, AZ…

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 23

National Provider Directory

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

Other organizations with this tax ID 25

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

View all 25

Locations

114 E Sunbridge Dr
Fayetteville, AR 72703
Phone (479) 463-2597

1420 Highway 62 65 N
Harrison, AR 72601
Phone (870) 741-3600

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345161600000",
    "number": "1699023895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 HIGHWAY 62 65 N",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726011959",
            "telephone_number": "870-741-3600",
            "fax_number": "870-741-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 HIGHWAY 62 65 N",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726011959",
            "telephone_number": "870-741-3600",
            "fax_number": "870-741-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON REGIONAL MEDICAL SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-17",
        "last_updated": "2012-08-17",
        "status": "A",
        "authorized_official_last_name": "CASH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR OF CLINIC OPERATIONS",
        "authorized_official_telephone_number": "479-463-1390"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Medical Clinic - Washington Regional",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrison, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.