Organization Active NPI

Hanan Khadam-Makhoul, M.D., P.a.

Doing business as Arkansas Pulmonary Clinic

  • Pulmonary Disease Physician
  • Little Rock, AR
National Provider Identifier
1053774760
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
HANAN KHADAM-MAKHOUL, M.D., P.A.
Doing business as
Arkansas Pulmonary Clinic
Practice address
9601 Baptist Health Dr
560
Little Rock, AR 72205-6321
Phone
(501) 225-6602
NPI assigned
Mar 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

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

Authorized official

Name
Dr. Hanan Makhoul, M.D.
Title
Owner
Phone
(501) 225-6602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

9601 Baptist Health Dr
560
Little Rock, AR 72205-6321

Mailing address

9601 Baptist Health Dr
560
Little Rock, AR 72205-6321
Phone (501) 225-6602

Other names 1

  • Arkansas Pulmonary Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160627002363 AR Part B Supplier - Clinic/Group Practice 4789975418 Receives reassigned benefits from 1 practitioner
Practice locations: Little Rock, AR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2113337Arkansas Pulmonary Clinic9601 Baptist Health Drive, Suite 560, Little Rock, AR 72205Certificate of waiverMay 18, 2028

National Provider Directory

National Provider Directory

Locations

9601 Baptist Health Dr
Ste 560
Little Rock, AR 72205
Phone (501) 225-6602

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": "1459296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1053774760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 BAPTIST HEALTH DR",
            "address_2": "560",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056321",
            "telephone_number": "501-225-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 BAPTIST HEALTH DR",
            "address_2": "560",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056321",
            "telephone_number": "501-225-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANAN KHADAM-MAKHOUL, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-30",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "MAKHOUL",
        "authorized_official_first_name": "HANAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-225-6602",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arkansas Pulmonary Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.