Zain Blackwell
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Little Rock, AR
NPI 1003645151 · NPPES record last updated Jul 29, 2024
Key facts
- NPI
- 1003645151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 4301 W Markham St
Little Rock, AR 72205-7101 - Phone
- (501) 686-8000
- NPI assigned
- Jul 29, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260626001644 | IN | Order and Referring Only - Internal Medicine |
1254804636 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
4301 W Markham St
Little Rock, AR 72205-7101
Mailing address
121 N Spruce St
Little Rock, AR 72205-3834
Phone (479) 684-8023
Other providers in Little Rock, AR
- Lonzell Blackmon
- Anna Blackshare
- London Elizabeth Blackwell-Dyer
- Lashay Blackwell
- Rhonda Blackwell
- Ashley Blackwood
- Robert Blagg
- Sara Bransford Blair
- Susan Diane Blair
- Tykeira Blair
All providers in Little Rock, AR · Student in an Organized Health Care Education/Training Program in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.