Active NPI
Michael Edward Coltrain II, MD
- Internal Medicine Physician
- Little Rock, AR
National Provider Identifier
1013371848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- E-12297
- Practice address
- 4300 W 7TH St
Little Rock, AR 72205-5446 - Phone
- (501) 257-1000
- NPI assigned
- Apr 7, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | E-12297 | AR | Primary |
Addresses
Primary practice location
4300 W 7TH St
Little Rock, AR 72205-5446
Mailing address
4300 W 7TH St
Little Rock, AR 72205-5446
Phone (501) 257-1000
Other practice location 1
4301 W Markham St # 634
Little Rock, AR 72205-7101
Phone (501) 686-5356
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 214179795 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-12297 | AR | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558310400000",
"number": "1013371848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 W 7TH ST",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722055446",
"telephone_number": "501-257-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 W 7TH ST",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722055446",
"telephone_number": "501-257-1000"
}
],
"practiceLocations": [
{
"address_1": "4301 W Markham St # 634",
"address_purpose": "LOCATION",
"city": "Little Rock",
"state": "AR",
"postal_code": "722057101",
"country_code": "US",
"telephone_number": "501-686-5356",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLTRAIN",
"first_name": "MICHAEL",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-07",
"last_updated": "2019-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AR",
"license": "E-12297",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "214179795",
"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 May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.