Individual provider Active NPI

Mouad Abdulrahim, MD

  • Psychiatry Physician
  • North Little Rock, AR
National Provider Identifier
1033797451
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
E-17484 Issued in AR
Practice address
3201 Springhill Dr Ste 300
North Little Rock, AR 72117-2909
Phone
(501) 753-4132
NPI assigned
Mar 29, 2021
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X E-17484 AR Primary

Addresses

Primary practice location

3201 Springhill Dr Ste 300
North Little Rock, AR 72117-2909

Mailing address

3709 Newlon Rd
Fort Smith, AR 72904-2118
Phone (479) 831-9098

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
I20250103001906 AR Practitioner - Psychiatry 3476962457 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Arkansas College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4253 N Crossover Rd
Fayetteville, AR 72703-4593
Phone (479) 521-5731

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texarkana Behavioral Associates, L.C. CurrentSince Mar 1, 2025 Accepting new patients
Texarkana Behavioral Associates, L.C. Current Accepting new patients
Texarkana Behavioral Associates, L.C. CurrentSince Mar 1, 2025 Accepting new patients
The Bridgeway, LLC CurrentSince Oct 22, 2024 Accepting new patients

Locations

10301 Mayo Dr
Barling, AR 72923
Phone (479) 494-5760

815 Fort St
Ste A
Barling, AR 72923
Phone (479) 494-5740

4253 N Crossover Rd
Fayetteville, AR 72703
Phone (479) 443-6496

21 Bridgeway Rd
North Little Rock, AR 72113
Phone (501) 771-1500

Organizations & group practices 4

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": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1033797451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 NEWLON RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729042118",
            "telephone_number": "479-831-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 SPRINGHILL DR STE 300",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172909",
            "telephone_number": "501-753-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDULRAHIM",
        "first_name": "MOUAD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "E-17484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.