Individual provider Active NPI

Lance Wade Weathers, MD

  • Cardiovascular Disease Physician
  • Rogers, AR
National Provider Identifier
1902086119
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
E-7387 Issued in AR
Practice address
2708 Rife Medical Lane
Ste 220
Rogers, AR 72758-1452
Phone
(479) 338-4400
Fax
(479) 338-4445
NPI assigned
Nov 6, 2007
Last updated
Dec 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-7387 AR
Cardiovascular Disease Physician 207RC0000X E-7387 AR Primary

Addresses

Primary practice location

2708 Rife Medical Lane
Ste 220
Rogers, AR 72758-1452

Mailing address

2708 Rife Medical Lane
Ste 220
Rogers, AR 72758-1452
Phone (479) 338-4400

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
I20120706000490 AR Practitioner - Cardiovascular Disease (Cardiology) 1355426388 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Mercy Way
Bella Vista, AR 72714-3000
Phone (479) 802-5555

207 Carter St
Berryville, AR 72616-4303
Phone (870) 423-6661

211 Carter St
Berryville, AR 72616-4303
Phone (870) 423-3338

2708 S Rife Medical LN
Suite T30
Rogers, AR 72758-1458
Phone (479) 338-3999

2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone (479) 636-0200

3101 SE 14TH St
Bentonville, AR 72712-4900
Phone (479) 631-2100

4600 Mercy LN
Springdale, AR 72762-3070

613 Orchard Dr
Berryville, AR 72616-5013
Phone (479) 338-4400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting68
Leg revascularization (restoring blood flow)17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-7387ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Dec 15, 2020 Accepting new patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
Mercy Health Northwest Arkansas Communities Internal Medicine CurrentSince Jun 25, 2012 Accepting new patients
Mercy Clinic Springfield Communities Current Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Jun 25, 2012 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Dec 15, 2020 Accepting new patients

Locations

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

214 Carter St
Berryville, AR 72616
Phone (870) 423-3355

2708 S Rife Medical Ln
Ste 220
Rogers, AR 72758
Phone (479) 338-4400

Interoperability endpoints

  • Direct secure messaging: lweathers265726@directc.mercy.net

Organizations & group practices 6

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

Hospital & facility affiliations 4

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": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1902086119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 RIFE MEDICAL LANE",
            "address_2": "STE 220",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-338-4400",
            "fax_number": "479-338-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 RIFE MEDICAL LANE",
            "address_2": "STE 220",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-338-4400",
            "fax_number": "479-338-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERS",
        "first_name": "LANCE",
        "middle_name": "WADE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-06",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-7387",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AR",
            "license": "E-7387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.