Individual provider Active NPI

Thomas W Atkinson, M.D.

  • Internal Medicine Physician
  • Fayetteville, AR
National Provider Identifier
1861438665
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C-5953 Issued in AR
Practice address
1670 E Joyce Blvd
Fayetteville, AR 72703-6214
Phone
(479) 582-5905
Fax
(479) 582-5908
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) Physician 207RA0401X C-5953 AR
Internal Medicine Physician 207R00000X C-5903 AR
Internal Medicine Physician 207R00000X C-5953 AR Primary

Addresses

Primary practice location

1670 E Joyce Blvd
Fayetteville, AR 72703-6214

Mailing address

PO Box 9690
Fayetteville, AR 72703-0030
Phone (479) 582-5905

Other identifiers 4

IdentifierTypeStateIssuer
238882OtherARVALUE OPTIONS PROVIDER ID
110911001MedicaidAR
13075000001OtherARQUALCHOICE QCA
50083OtherARBLUE CROSS

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
I20050107000324 AR Practitioner - Internal MedicinePractitioner - Addiction Medicine 4880642719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Addiction Medicine
Education
University of Arkansas College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1670 E Joyce Blvd
Suite 2
Fayetteville, AR 72703-0030

P O Box
9690 1792 E. Joyce Blvd Suite 5
Fayetteville, AR 72703-0030

PO Box
Suite 9690
Fayetteville, AR 72703-0030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C-5903ARMDInternal Medicine Physician
C-5953ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texarkana Behavioral Associates LC CurrentSince Nov 17, 2002 Accepting new patients
Texarkana Behavioral Associates, L.C. Current Accepting new patients
Texarkana Behavioral Associates, L.C. CurrentSince Nov 17, 2002 Accepting new patients
Springdale Treatment Center, LLC CurrentSince Dec 22, 2021 Accepting new patients
Ancillary Innovations Past Accepting new patients
Integrated Health Associates PastSince Jan 1, 1990 Accepting new patients
Arkansas MRI Services, LLC Past Accepting new patients
Arkansas MRI Services LLC Past Accepting new patients

Locations

815 Fort St
Ste A
Barling, AR 72923
Phone (479) 494-5740

4253 N Crossover Rd
Fayetteville, AR 72703
Phone (479) 443-6496

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1861438665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9690",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727030030",
            "telephone_number": "479-582-5905",
            "fax_number": "479-582-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 E JOYCE BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036214",
            "telephone_number": "479-582-5905",
            "fax_number": "479-582-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKINSON",
        "first_name": "THOMAS",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "AR",
            "license": "C-5953",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "C-5903",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "C-5953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PROVIDER ID",
            "identifier": "238882",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110911001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE QCA",
            "identifier": "13075000001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "50083",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.