NPIMap

Organization Active NPI

Evgueni Roudachevski, D.O.

  • Geriatric Medicine (Internal Medicine) Physician
  • Little Rock, AR
National Provider Identifier
1023569852
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
E-2957 Issued in AR
Legal business name
EVGUENI ROUDACHEVSKI, D.O.
Practice address
11912 Kanis Rd
Suite F2
Little Rock, AR 72211-3733
Phone
(501) 227-8020
Fax
(501) 227-8826
NPI assigned
Oct 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Authorized official

Name
Evgueni Roudachevski, D.O.NPI 1215993787
Title
Owner
Phone
(501) 227-8020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X E-2957 AR Primary

Addresses

Primary practice location

11912 Kanis Rd
Suite F2
Little Rock, AR 72211-3733

Mailing address

11912 Kanis Rd
Suite F2
Little Rock, AR 72211-3733
Phone (501) 227-8020

National Provider Directory

National Provider Directory
Tax ID family
Evgueni Roudachevski DO2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476662400000",
    "number": "1023569852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11912 KANIS RD",
            "address_2": "SUITE F2",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113733",
            "telephone_number": "501-227-8020",
            "fax_number": "501-227-8826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11912 KANIS RD",
            "address_2": "SUITE F2",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113733",
            "telephone_number": "501-227-8020",
            "fax_number": "501-227-8826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVGUENI ROUDACHEVSKI, D.O.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A",
        "authorized_official_last_name": "ROUDACHEVSKI",
        "authorized_official_first_name": "EVGUENI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-227-8020",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AR",
            "license": "E-2957",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 17, 2016; 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.