Individual provider Active NPI

Charles Andrew Lavender

  • Gastroenterology Physician
  • Springdale, AR
National Provider Identifier
1720584378
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
E-14012 Issued in AR
Practice address
3901 Parkway Cir Ste 550
Springdale, AR 72762-6362
Phone
(479) 346-1850
Fax
(479) 346-1851
NPI assigned
Apr 3, 2018
Last updated
Jul 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X E-14012 AR Primary

Addresses

Primary practice location

3901 Parkway Cir Ste 550
Springdale, AR 72762-6362

Mailing address

3901 Parkway Cir Ste 550
Springdale, AR 72762-6362
Phone (479) 346-1850

Other practice location 1

3700 SE Dodson Rd Ste 2
Bentonville, AR 72712-3728
Phone (479) 763-3501

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
I20210810000025 AR Practitioner - Internal Medicine 6406103951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arkansas College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3901 Pkwy Cir
Suite 550
Springdale, AR 72762-6362
Phone (479) 346-1850

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy21
Upper gastrointestinal (GI) endoscopy for acid reflux24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-14012ARMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Texas Digestive Disease Consultants, PLLC Gastroenterology Past Accepting new patients

Locations

10850 White Rock Rd
Rancho Cordova, CA 95670

Organizations & group practices 3

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": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1720584378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 PARKWAY CIR STE 550",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626362",
            "telephone_number": "479-346-1850",
            "fax_number": "479-346-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 PARKWAY CIR STE 550",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626362",
            "telephone_number": "479-346-1850",
            "fax_number": "479-346-1851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3700 SE Dodson Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Bentonville",
            "state": "AR",
            "postal_code": "727123728",
            "country_code": "US",
            "telephone_number": "479-763-3501",
            "fax_number": "479-763-3502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAVENDER",
        "first_name": "CHARLES",
        "middle_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AR",
            "license": "E-14012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

Verify at the official NPI Registry.