Individual provider Active NPI

Jefferson Robert Thurlby, M.D.

  • Anesthesiology Physician
  • Fayetteville, AR
National Provider Identifier
1790758985
Registry record updated Apr 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
E7407 Issued in AR
Practice address
3215 N Northhills Blvd
Fayetteville, AR 72703-4424
Phone
(479) 463-1000
Fax
(479) 463-5573
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 21664 OK
Anesthesiology Physician 207L00000X 0101242416 VA
Anesthesiology Physician 207L00000X E7407 AR Primary

Addresses

Primary practice location

3215 N Northhills Blvd
Fayetteville, AR 72703-4424

Mailing address

PO Box 1867
Fayetteville, AR 72702-1867
Phone (877) 898-9892

Other identifiers 1

IdentifierTypeStateIssuer
191009001MedicaidAR

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
I20101228000300 AR Practitioner - Anesthesiology 8729118831 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Anesthesia of Arkansas Professional CorporationGroup PAC ID 6406077460, 87 clinicians
Renew Medical Group of Arkansas LTDGroup PAC ID 3173056298, 129 clinicians

Practice addresses (Care Compare)

3215 N N Hills Blvd
Fayetteville, AR 72703-4424
Phone (479) 463-1000

7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone (479) 314-6000

Hospital & facility affiliations

  • Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010
  • Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21664OKMDCounselor
E7407ARMDAnesthesiology Physician
0101242416VAMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of Arkansas Professional Corporation Anesthesiology CurrentSince May 10, 2014 Accepting new patients
Anesthesia Services of Benton County PA Anesthesiology CurrentSince Apr 2, 2015 Accepting new patients
Renew Medical Group of Arkansas LTD Anesthesiology CurrentSince Feb 1, 2025 Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1000

3215 N Northhills Blvd
Ste B
Fayetteville, AR 72703
Phone (479) 463-1000

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804

Interoperability endpoints

  • Direct secure messaging: jthurlby49932@washingtonregional.direct-ci.com

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 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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334620800000",
    "number": "1790758985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1867",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727021867",
            "telephone_number": "877-898-9892",
            "fax_number": "918-392-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 N NORTHHILLS BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034424",
            "telephone_number": "479-463-1000",
            "fax_number": "479-463-5573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THURLBY",
        "first_name": "JEFFERSON",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2012-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "21664",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101242416",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E7407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191009001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.