NPIMap

Individual provider Active NPI

Shaun Randolph Senter, MD

  • Interventional Cardiology Physician
  • Fayetteville, AR
National Provider Identifier
1972659480
Registry record updated Mar 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
E-6974 Issued in AR
Practice address
3211 N Northhills Blvd
Suite 110
Fayetteville, AR 72703-4007
Phone
(479) 571-4338
Fax
(479) 571-4015
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X E-6974 AR
Interventional Cardiology Physician 207RI0011X E-6974 AR Primary
Internal Medicine Physician 207R00000X E-6974 AR

Addresses

Primary practice location

3211 N Northhills Blvd
Suite 110
Fayetteville, AR 72703-4007

Mailing address

3211 N Northhills Blvd
Suite 110
Fayetteville, AR 72703-4007
Phone (479) 571-4338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110729000416 AR Practitioner - Cardiovascular Disease (Cardiology) 9830279645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Rush Medical College of Rush University, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Regional Medical SystemGroup PAC ID 8820995434, 238 clinicians

Practice addresses (Care Compare)

3211 N N Hills Blvd
Suite 110
Fayetteville, AR 72703-5602
Phone (479) 571-4338

Hospital & facility affiliations

  • Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004
  • North Arkansas Regional Medical Center Hospital, Harrison, AR, CCN 040017
  • Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010
  • Northwest Medical Center-Springdale Hospital, Springdale, AR, CCN 040022
  • Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting77
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-6974ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Regional Medical System CurrentSince Feb 17, 2016 Accepting new patients
Washington Regional Medical System Interventional Cardiology CurrentSince Feb 17, 2016 Accepting new patients
Northwest Benton County Physician Services LLC Past Accepting new patients
Washington Regional Medical System Past Accepting new patients

Locations

3211 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-4444

3211 N Northhills Blvd
Ste 110
Fayetteville, AR 72703
Phone (479) 571-4338

Interoperability endpoints

  • Direct secure messaging: ssenter21352@washingtonregional.direct-ci.com
  • Direct secure messaging: ssenter@walkerheart.gwaydirect.com

Organizations & group practices 4

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 6

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1972659480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 N NORTHHILLS BLVD",
            "address_2": "SUITE 110",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034007",
            "telephone_number": "479-571-4338",
            "fax_number": "479-571-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 N NORTHHILLS BLVD",
            "address_2": "SUITE 110",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034007",
            "telephone_number": "479-571-4338",
            "fax_number": "479-571-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENTER",
        "first_name": "SHAUN",
        "middle_name": "RANDOLPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AR",
            "license": "E-6974",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AR",
            "license": "E-6974",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-6974",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.