Organization Active NPI

Arkansas Allergy & Asthma Clinic, P.a.

  • Allergy & Immunology Physician
  • Little Rock, AR
National Provider Identifier
1003877853
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
ARKANSAS ALLERGY & ASTHMA CLINIC, P.A.
Practice address
5 Executive Center CT
Little Rock, AR 72211-4375
Phone
(501) 227-5210
Fax
(501) 312-1592
NPI assigned
Mar 31, 2006
Last updated
Mar 6, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Authorized official

Name
Pam Wells
Title
Administrator
Phone
(501) 227-5210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X Primary

Addresses

Primary practice location

5 Executive Center CT
Little Rock, AR 72211-4375

Mailing address

PO Box 55090
Little Rock, AR 72215-5090
Phone (501) 227-5210

Other identifiers 1

IdentifierTypeStateIssuer
104277002MedicaidAR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551830400000",
    "number": "1003877853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55090",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722155090",
            "telephone_number": "501-227-5210",
            "fax_number": "501-312-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 EXECUTIVE CENTER CT",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114375",
            "telephone_number": "501-227-5210",
            "fax_number": "501-312-1592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS ALLERGY & ASTHMA CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "last_updated": "2019-03-06",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "501-227-5210"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104277002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.