Washington Regional Medicorp, Inc.

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

AR 2926 Issued in AR

Legal business name

WASHINGTON REGIONAL MEDICORP, INC.

Doing business as

Fayetteville City Hospital-Transitions

Practice address

221 S School Ave
Fayetteville, AR 72701-5969

Phone

(479) 442-5100

Fax

(479) 442-7395

NPI assigned

Jan 18, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jack Bryant Morris

Title

Administrator

Phone

(479) 713-1009

Specialties & licenses 1

Addresses

Other names 1

• Fayetteville City Hospital-Transitions Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821140815. Details of each certification follow.

• CCN 044015 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 044015

Legal name

FAYETTEVILLE CITY HOSP & GERATRIC CTR

Certification status

Terminated Voluntary: merger or closure, Nov 5, 2009

Provider type (POS)

Hospital – Psychiatric

Participating since

Feb 4, 1994

Last certification

Jun 22, 2007

Beds

10

Ownership / control type

Private (not for profit)

Facility address

221 South School Street
Fayetteville, AR 72701

Locations

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821140815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 S SCHOOL AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727015969",
            "telephone_number": "479-442-5100",
            "fax_number": "479-442-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 S SCHOOL AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727015969",
            "telephone_number": "479-442-5100",
            "fax_number": "479-442-7395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON REGIONAL MEDICORP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "BRYANT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "479-713-1009",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "AR",
            "license": "AR 2926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fayetteville City Hospital-Transitions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Washington Regional Medical System (Washington Regional Internal Medicine Associates)
• Washington Regional Medical System (Washington Regional Gastroenterology Clinic)
• Washington Regional Medical System (Northwest Arkansas Neurosurgery Clinic - Washington Regional)
• Washington Regional Medical System (Washington Regional Specialty Clinic)
• Washington Regional Medical System (Washington Regional Ozark Surgical Clinic)
• Washington Regional Medicorp, Inc. (Fayetteville City Hospital and Geriatric Center)
• Kristi Michelle Washington, LPC, LMFT
• Melissa Anne Waterhouse, PHARMD
• Watkins Family Health & Counseling, Inc.
• Watkins Family Health & Counseling, Inc.

• General Acute Care Hospital in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• General Acute Care Hospital in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.