Individual provider Active NPI

Jeffrey Lynn Arnold, M.D.

  • Family Medicine Physician
  • Waco, TX
National Provider Identifier
1740289800
Registry record updated Mar 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J1445 Issued in TX
Practice address
6614 Sanger Ave
Waco, TX 76710-4253
Phone
(254) 537-6100
Fax
(254) 537-6101
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J1445 TX Primary
Emergency Medicine Physician 207P00000X J1445 TX

Addresses

Primary practice location

6614 Sanger Ave
Waco, TX 76710-4253

Mailing address

PO Box 22010
Waco, TX 76702-2010
Phone (254) 761-8811

Other identifiers 2

IdentifierTypeStateIssuer
121270605MedicaidTX
OON59XOtherTXBCBS TEXAS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100302000651 TX Practitioner - Family PracticePractitioner - Emergency Medicine 3577552751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health AllianceGroup PAC ID 6305731068, 119 clinicians

Practice addresses (Care Compare)

6614 Sanger Ave
Waco, TX 76710-4253
Phone (254) 537-6100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health Alliance CurrentSince Nov 8, 2010 Accepting new patients
Providence Health Alliance CurrentSince Nov 8, 2010 Accepting new patients

Locations

701 McClintic Dr
Lake Limestone, TX 76642
Phone (254) 729-3281

318 Richland West Cir
Waco, TX 76712
Phone (254) 776-8008

6614 Sanger Ave
Waco, TX 76710
Phone (254) 537-6100

6901 Medical Pkwy
Waco, TX 76712
Phone (254) 751-4000

301 Richland West Cir
Waco, TX 76712
Phone (254) 537-6200

Interoperability endpoints

  • Direct secure messaging: jeffrey.arnold.1@9635.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299456000000",
    "number": "1740289800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22010",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767022010",
            "telephone_number": "254-761-8811",
            "fax_number": "254-761-8815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6614 SANGER AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767104253",
            "telephone_number": "254-537-6100",
            "fax_number": "254-537-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "JEFFREY",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2011-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J1445",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J1445",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121270605",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TEXAS",
            "identifier": "OON59X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.