WASHINGTON REGIONAL FAMILY CLINIC FAYETTEVILLE
NPI 1114971819
Family Medicine in Fayetteville, AR
About Washington Regional Family Clinic Fayetteville NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WASHINGTON REGIONAL FAMILY CLINIC FAYETTEVILLE (NPI 1114971819) is a healthcare organization registered as a family medicine in Fayetteville, Arkansas and active in the NPI registry since May 2006. The organization holds a CLIA Microscopy certificate valid through October 27, 2028 and lists Mary Jo Rothrock, Director Clinic Administration, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Washington Regional Family Clinic Fayetteville is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
18Medicare enrollment records show 18 clinicians reassign Medicare billing to Washington Regional Family Clinic Fayetteville, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 11 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 5
Clinicians, nearest first (18)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate for Provider-Performed Microscopy Procedures (PPMP) 04D1091249
Washington Regional Family Clinic Fayetteville Washington Regional Medical System · Fayetteville, ARFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Washington Regional Medical System's NPI number?
The NPI number for Washington Regional Medical System is 1114971819. It was assigned to this organization in the NPPES registry on May 19, 2006. The provider is doing business as Washington Regional Family Clinic Fayetteville.
Where is Washington Regional Medical System located?
Washington Regional Medical System is located at 3053 N College Avenue, Fayetteville, AR 72703. The listed phone number is (479) 463-2000.
What is Washington Regional Medical System's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Washington Regional Medical System enrolled in Medicare?
Yes. Washington Regional Medical System is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Washington Regional Medical System?
According to the CMS Revalidation Reassignment List (October 2026 release), 18 clinicians in 5 Medicare specialties reassign their Medicare billing to Washington Regional Medical System. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Internal Medicine (8), Family Practice (6) and Nurse Practitioner (2). Of these, 1 practice at this address and 11 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Washington Regional Medical System hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 04D1091249) is associated with this NPI, valid through October 27, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Washington Regional Medical System accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Washington Regional Medical System as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Washington Regional Medical System was last updated on March 25, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Washington Regional Family Clinic Fayetteville · NPI 1114971819
Family Medicine organization in Fayetteville, Arkansas. Organization record, active in the CMS NPPES registry since May 19, 2006.
## Identity
- **NPI:** 1114971819 (Entity type: Organization)
- **Enumerated:** May 19, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Washington Regional Medical System
- **Organization subpart:** No
- **Authorized official:** Mary Rothrock, DIRECTOR CLINIC ADMINISTRATION
## Practice location
- **Address:** 3053 N COLLEGE AVENUE, Fayetteville, AR 72703
- **Phone:** (479) 463-2000 · **Fax:** (479) 442-4518
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 18 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (8), Family Practice (6), Nurse Practitioner (2); 1 practice at this address and 11 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 25, 2008
- **Other identifiers:** Medicare ID-Type Unspecified 5B608 (AR)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1114971819) · Data from the CMS NPPES public registry.