Active NPI
Timothy Wayne Yawn, MD
- Family Medicine Physician
- Rogers, AR
National Provider Identifier
1801869185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- C7558
- Practice address
- 1615W Persimmon St B
Rogers, AR 72756-3383 - Phone
- (479) 636-7192
- Fax
- (479) 631-8212
- NPI assigned
- Feb 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | C7558 | AR | Primary |
Addresses
Primary practice location
1615W Persimmon St B
Rogers, AR 72756-3383
Mailing address
1615 W Persimmon St
Rogers, AR 72756-3383
Phone (479) 636-7192
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 115750001 | Medicaid | AR | |
| 080050005 | Other | AR | RAILROAD MEDICARE |
| 52435 | Other | AR | BLUE CROSS BLUE SHIELD |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Arkansas College of Medicine, 1988
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1615 W Persimmon St
Suite B
Rogers, AR 72756-3383
Phone (479) 636-7192
Hospital & facility affiliations
- Mercy Home Health
- Northwest Home Health
- Elite Home Health
- Mercy Hospital Northwest Arkansas
- Northwest Medical Center-Springdale
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C7558 | AR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rogers Family and Occupational Medicine Clinic | Family Medicine | Current | Accepting new patients |
Locations
1615 W Persimmon St
Ste B
Rogers, AR 72756
Phone (479) 636-7192
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Rogers, AR
- NPI 1801869151
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Mercy Hospital Northwest Arkansas
- General Acute Care Hospital
- Rogers, AR
- NPI 1316902414
-
- Home Health Agency
- Rogers, AR
- NPI 1942265160
-
dba Northwest Medical Center
- General Acute Care Hospital
- Springdale, AR
- NPI 1699726695
-
dba Access Home Health
- Home Health Agency
- Springdale, AR
- NPI 1033161880
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444953600000",
"number": "1801869185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1615 W PERSIMMON ST",
"city": "ROGERS",
"state": "AR",
"postal_code": "727563383",
"telephone_number": "479-636-7192",
"fax_number": "479-621-9749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1615W PERSIMMON ST B",
"city": "ROGERS",
"state": "AR",
"postal_code": "727563383",
"telephone_number": "479-636-7192",
"fax_number": "479-631-8212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAWN",
"first_name": "TIMOTHY",
"middle_name": "WAYNE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-08",
"last_updated": "2015-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "C7558",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "115750001",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080050005",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "52435",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rogers, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.