Individual provider Active NPI

Mary Denise Compton, PHD

  • Clinical Psychologist
  • Little Rock, AR
National Provider Identifier
1053490649
Registry record updated Apr 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
10-27P Issued in AR
Practice address
4301 W Markham St # 748
Little Rock, AR 72205-7101
Phone
(501) 686-8000
Fax
(501) 686-6234
NPI assigned
Nov 3, 2006
Last updated
Apr 23, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 10-27P AR Primary

Addresses

Primary practice location

4301 W Markham St # 748
Little Rock, AR 72205-7101

Mailing address

4301 W Markham St # 748
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other identifiers 1

IdentifierTypeStateIssuer
184870719MedicaidAR

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110113001033 AR Practitioner - Clinical Psychologist 3678644317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4301 W Markam St
Little Rock, AR 72205-7101

629 Jack Stephens Dr
Little Rock, AR 72205-5525
Phone (501) 686-8000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Nov 5, 2010 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Nov 5, 2010 Accepting new patients
Cotler Healthcare & Development Inc. Clinical Past Accepting new patients

Locations

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

4301 W Markham St
#748
Little Rock, AR 72205
Phone (501) 526-6860

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

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Presbyterian Village Inc.Little Rock, AR, CCN 045436 Skilled nursing facility Corporate Director May 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1053490649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 748",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-686-6234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 748",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-686-6234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMPTON",
        "first_name": "MARY DENISE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "10-27P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184870719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.