WASHINGTON REGIONAL FAMILY CLINIC FAYETTEVILLE
NPI 1114971819
Family Medicine in Fayetteville, AR
NPI Status: Active since May 19, 2006
Contact Information
3053 N COLLEGE AVENUE
FAYETTEVILLE, AR
ZIP 72703
Phone: (479) 463-2000
Fax: (479) 442-4518
- Organization
- Family Medicine
- Accepts Insurance
- CLIA Number: 04D1091249
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-27-2026
About WASHINGTON REGIONAL FAMILY CLINIC FAYETTEVILLE
This page provides the complete NPI Profile along with additional information for Washington Regional Family Clinic Fayetteville, a primary care provider established in Fayetteville, Arkansas operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1114971819 assigned on May 2006. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 18 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Washington Regional Family Clinic Fayetteville. The authorized official of this NPI record is Mary Jo Rothrock (Director Clinic Administration)
- NPI
- 1114971819
- Provider Legal Name
- WASHINGTON REGIONAL MEDICAL SYSTEM
- Other Organization Name
- WASHINGTON REGIONAL FAMILY CLINIC FAYETTEVILLE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 3053 N COLLEGE AVENUE FAYETTEVILLE, AR 72703
- Location Phone
- (479) 463-2000
- Location Fax
- (479) 442-4518
- Mailing Address
- PO BOX 879 FAYETTEVILLE, AR 72702
- Mailing Phone
- (479) 713-7115
- Mailing Fax
- (479) 442-4518
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-19-2006
- Last Update Date
- 03-25-2008
- Code Navigator
A primary care provider (PCP) like Washington Regional Family Clinic Fayetteville sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA (QualChoice) - POS
- Complete Gold - PPO
- Complete Gold + Vision + Adult Dental - PPO
- Complete Silver (QualChoice) - POS
- Connected Silver - PPO
- Connected Silver (QualChoice) - POS
- Connected Silver (QualChoiceLife) - PPO
- Connected Silver + Vision + Adult Dental - PPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold - PPO
- Elite Gold + Vision + Adult Dental - PPO
- Everyday Bronze - PPO
- Everyday Bronze + Vision + Adult Dental - PPO
- Everyday Gold - PPO
- Everyday Gold + Vision + Adult Dental - PPO
- Focused Silver - PPO
- Focused Silver + Vision + Adult Dental - PPO
- Clear Silver - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5B608 | MEDICARE ID-TYPE UNSPECIFIED (04) | AR |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 04D1091249
- Facility Type
- Physician Office
- Certificate Effective Date
- October 28, 2024
- Certificate Expiration Date
- October 27, 2026
- Laboratory Director
- DR. DAVID G. RATCLIFF
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Washington Regional Family Clinic Fayetteville in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 1 | 4 | 9 | 7 | 1 | 8 | 1 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 2 | 4 | 18 | 7 | 2 | 8 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 2 + 4 + 1 + 8 + 7 + 2 + 8 + 2 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1114971819 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1164472908 | JOHNNY P ADKINS MD Individual | General Practice | 3053 N COLLEGE AVENUE FAYETTEVILLE, AR 72703 (479) 463-2000 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1114971819, enumerated in the NPI registry as an "organization" on May 19, 2006
The provider is located at 3053 N College Avenue Fayetteville, Ar 72703 and the phone number is (479) 463-2000
This medical organization specializes in Family Medicine with taxonomy code 207Q00000X
The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 04D1091249 for a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on May 19, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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