NPIMap

Individual provider Active NPI

Heath Tyson Mitchell, MD

  • Internal Medicine Physician
  • Malvern, AR
National Provider Identifier
1053872176
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E-15694 Issued in AR
Practice address
1001 Schneider Dr
Malvern, AR 72104-4811
Phone
(501) 851-7402
Fax
(501) 851-4753
NPI assigned
Mar 29, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X E-15694 AR Primary

Addresses

Primary practice location

1001 Schneider Dr
Malvern, AR 72104-4811

Mailing address

11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (501) 851-7402

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
I20220829003782 AR Practitioner - Internal Medicine 7719212281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

1701 Club Manor Dr
Suite 2B
Maumelle, AR 72113-7401
Phone (501) 851-7402

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-15694ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Arkansas Health Group CurrentSince Aug 1, 2022 Accepting new patients

Locations

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

9601 Interstate 630
#7
Little Rock, AR 72205
Phone (501) 202-3995

1001 Schneider Dr
Malvern, AR 72104
Phone (501) 332-1000

1701 Club Manor Dr
#2B
Maumelle, AR 72113

1701 Club Manor Dr
Ste 2B
North Little Rock, AR 72113
Phone (501) 812-7216

3333 Springhill Dr
North Little Rock, AR 72117
Phone (501) 202-3000

Organizations & group practices 2

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": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1053872176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "501-851-7402",
            "fax_number": "501-851-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SCHNEIDER DR",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721044811",
            "telephone_number": "501-851-7402",
            "fax_number": "501-851-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "HEATH",
        "middle_name": "TYSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-15694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, AR

Sources for this page

Verify at the official NPI Registry.