Individual provider Active NPI

Amy W Cross, MD

  • Pediatrics Physician
  • Magnolia, AR
National Provider Identifier
1013917905
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
E2147 Issued in AR
Practice address
1617 N Washington
Magnolia, AR 71753-2046
Phone
(870) 234-7676
Fax
(870) 562-2559
NPI assigned
Jul 21, 2005
Last updated
Oct 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X E2147 AR Primary

Addresses

Primary practice location

1617 N Washington
Magnolia, AR 71753-2046

Mailing address

4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other practice location 1

306 E McNeil
Magnolia, AR 71753-2927
Phone (870) 234-5171

Other identifiers 1

IdentifierTypeStateIssuer
136968001MedicaidAR

Other names 1

  • Amy W Albin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110203000709 AR Practitioner - Pediatric Medicine 4688854904 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E2147ARMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Jan 1, 2025 Accepting new patients
Magnolia Pediatric Clinic, Inc. Pediatrics CurrentSince Nov 13, 2010 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients

Locations

620 W Grove St
Ste 202
El Dorado, AR 71730
Phone (870) 863-2420

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

1617 N Washington
Magnolia, AR 71753
Phone (870) 234-7676

306 E McNeil
Magnolia, AR 71753
Phone (870) 234-5171

1601 W 40th Ave
Pine Bluff, AR 71603

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25257/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1013917905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 N WASHINGTON",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532046",
            "telephone_number": "870-234-7676",
            "fax_number": "870-562-2559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 E McNeil",
            "address_purpose": "LOCATION",
            "city": "Magnolia",
            "state": "AR",
            "postal_code": "717532927",
            "country_code": "US",
            "telephone_number": "870-234-5171",
            "fax_number": "870-234-0507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROSS",
        "first_name": "AMY",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E2147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136968001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "ALBIN",
            "middle_name": "W",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Magnolia, AR

Sources for this page

Verify at the official NPI Registry.