| Washington Regional Senior Clinic | |
|
12 E Appleby Rd Washington Regional Senior Clinic Fayetteville AR 72703-3901 | |
| (479) 463-4444 | |
| (479) 463-4499 |
| Full Name | Washington Regional Senior Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 12 E Appleby Rd, Fayetteville, Arkansas |
| Authorized Official Name and Position | Daniel R Eckels (SENIOR VICE PRESIDENT/CFO) |
| Authorized Official Contact | 4794636026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Washington Regional Senior Clinic 12 E Appleby Rd Clinic Administration Fayetteville AR 72703-3901 Ph: (479) 463-1704 | Washington Regional Senior Clinic 12 E Appleby Rd Washington Regional Senior Clinic Fayetteville AR 72703-3901 Ph: (479) 463-4444 |
| NPI Number | 1699731208 |
|---|---|
| Provider Enumeration Date | 04/22/2006 |
| Last Update Date | 11/16/2009 |
| Medicare PECOS PAC ID | 8820995434 |
|---|---|
| Medicare Enrollment ID | O20050912001236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699731208 | NPI | - | NPPES |
| 158990002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Kim R Sheets |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710943659 PECOS PAC ID: 3274420518 Enrollment ID: I20040302000673 |
| Provider Name | Waqar M Mehal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043255128 PECOS PAC ID: 2264414432 Enrollment ID: I20040602000592 |
| Provider Name | Kristin M Bosc |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740246784 PECOS PAC ID: 2062479702 Enrollment ID: I20041215000026 |
| Provider Name | Stephen B Gemmell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508816422 PECOS PAC ID: 1355395138 Enrollment ID: I20050303001023 |
| Provider Name | Randy Shinn |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1538119458 PECOS PAC ID: 4385698166 Enrollment ID: I20050303001063 |
| Provider Name | Mary T Shinn |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1912957820 PECOS PAC ID: 3476594383 Enrollment ID: I20050519001142 |
| Provider Name | Heather L Terry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659448868 PECOS PAC ID: 6507885449 Enrollment ID: I20051121000276 |
| Provider Name | Antoinette L Hartman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215972252 PECOS PAC ID: 5799788287 Enrollment ID: I20060823000402 |
| Provider Name | Alan L Diamond |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831149020 PECOS PAC ID: 9032142674 Enrollment ID: I20060905000318 |
| Provider Name | Arlene U Nepomuceno |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1598765208 PECOS PAC ID: 5395723886 Enrollment ID: I20070216000229 |
| Provider Name | Truman S Shaddox |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1649236951 PECOS PAC ID: 0749211084 Enrollment ID: I20070529000037 |
| Provider Name | Margaret Fairchild Tremwel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063409993 PECOS PAC ID: 2264327261 Enrollment ID: I20081104000692 |
| Provider Name | Charles Tevebaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316959216 PECOS PAC ID: 1557423738 Enrollment ID: I20081222000655 |
| Provider Name | Emily J Coombs |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1073745873 PECOS PAC ID: 8123165008 Enrollment ID: I20110712000121 |
| Provider Name | Walker D Dyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043629900 PECOS PAC ID: 0749402014 Enrollment ID: I20141121000657 |
| Provider Name | Tiffany M Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114385374 PECOS PAC ID: 7719283159 Enrollment ID: I20160310000328 |
| Provider Name | Sarah A Highfill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922777051 PECOS PAC ID: 7315335718 Enrollment ID: I20211103001534 |
Community Clinic Fayetteville Medical Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3162 W Martin Luther King Blvd, Suites 13 & 14, Fayetteville, AR 72704 Phone: 479-935-4834 Fax: 479-751-2878 | |
K E Management Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1420 E Augustine Ln Ste 7, Fayetteville, AR 72703 Phone: 479-200-9812 Fax: 866-243-7203 | |
Bryan Abernathy Md Pa Dba Abernathy Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1806 N Crossover Rd, Suite 4, Fayetteville, AR 72701 Phone: 479-521-5603 Fax: 479-521-5773 | |
Truhealth Family Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2630 E Citizens Dr, Suite 3, Fayetteville, AR 72703 Phone: 479-527-9966 Fax: 479-527-9677 | |
Washington County Hiv Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3270 N. Wimberly Drive, Fayetteville, AR 72703 Phone: 479-973-8450 Fax: 479-973-8452 | |
Arcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1792 E Joyce Blvd, Fayetteville, AR 72703 Phone: 501-500-5001 Fax: 501-500-5001 | |
Dr James Dunn Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4368 E Churchill Dr, Fayetteville, AR 72701 Phone: 479-442-4553 Fax: 479-251-1006 |