NPIMap

Individual provider Active NPI

Oumitana Kajkenova, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Little Rock, AR
National Provider Identifier
1053401521
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
E-3224 Issued in AR
Practice address
2300 Andover CT Ste 400
Little Rock, AR 72227-3990
Phone
(501) 904-5159
Fax
(501) 904-5157
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-3224 AR
Geriatric Medicine (Internal Medicine) Physician 207RG0300X E-3224 AR Primary

Addresses

Primary practice location

2300 Andover CT Ste 400
Little Rock, AR 72227-3990

Mailing address

2300 Andover CT Ste 400
Little Rock, AR 72227-3990
Phone (501) 904-5159

Other identifiers 2

IdentifierTypeStateIssuer
154302001MedicaidAR
P00105908OtherARRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040622000006 AR Practitioner - Geriatric Medicine 4880679109 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arkansas Longevity Center PLLCGroup PAC ID 4183993082, 3 clinicians
Curana Health of Arkansas LLCGroup PAC ID 1658684675, 12 clinicians

Practice addresses (Care Compare)

2300 Andover CT
Suite 400
Little Rock, AR 72227-3990
Phone (337) 991-9276

609 SW 8TH St
6TH Floor
Bentonville, AR 72712-8913
Phone (337) 991-9276

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-3224ARMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Curana Health of Arkansas LLC CurrentSince Jan 1, 2024 Accepting new patients
Longevity Associates, PLLC Family Medicine CurrentSince Apr 28, 2017 Accepting new patients
Arkansas Longevity Center, PLLC Family Medicine CurrentSince Aug 1, 2017 Accepting new patients

Locations

609 SW 8th St
Fl 6
Bentonville, AR 72712
Phone (479) 349-2579

2300 Andover Ct
Ste 400
Little Rock, AR 72227
Phone (501) 319-7520

1 Saint Vincent Cir
Ste 150
Little Rock, AR 72205
Phone (501) 552-6830

1509 Dulles Dr
Lafayette, LA 70506
Phone (337) 408-0803

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16209/brand/1/csg/1/fhir/r4
  • Direct secure messaging: oumitana.kajkenova.1@16209.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1053401521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 ANDOVER CT STE 400",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722273990",
            "telephone_number": "501-904-5159",
            "fax_number": "501-904-5157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 ANDOVER CT STE 400",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722273990",
            "telephone_number": "501-904-5159",
            "fax_number": "501-904-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAJKENOVA",
        "first_name": "OUMITANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-3224",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AR",
            "license": "E-3224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154302001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00105908",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.