NPIMap

Individual provider Active NPI

Ethan P McMoran, MD

  • Vascular & Interventional Radiology Physician
  • Little Rock, AR
National Provider Identifier
1063973618
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
E-18922 Issued in AR
Practice address
500 S University Ave Ste 101
Little Rock, AR 72205-5314
Phone
(501) 664-3914
NPI assigned
Mar 27, 2019
Last updated
Aug 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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
Vascular & Interventional Radiology Physician 2085R0204X E-18922 AR Primary

Addresses

Primary practice location

500 S University Ave Ste 101
Little Rock, AR 72205-5314

Mailing address

500 S University Ave Ste 101
Little Rock, AR 72205-5314
Phone (501) 664-3914

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
I20250827001473 AR Practitioner - Interventional Radiology 5597090621 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
University of Arkansas College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical GroupGroup PAC ID 5698758803, 237 clinicians
Radiology Associates PAGroup PAC ID 7517953912, 103 clinicians

Practice addresses (Care Compare)

1 Mercy LN
Suite 404
Hot Springs, AR 71913-6441
Phone (501) 609-2222

2 Saint Vincent Cir
Little Rock, AR 72205-5423
Phone (501) 552-4666

500 S University Ave
Suite 101
Little Rock, AR 72205-5399
Phone (501) 664-3914

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-18922ARMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group CurrentSince Nov 1, 2025 Accepting new patients
Radiology Associates PA CurrentSince Jun 14, 2025 Accepting new patients
CHI St. Vincent Medical Group Hot Springs CurrentSince Oct 2, 2025 Accepting new patients

Locations

1 Mercy Ln
Ste 301
Hot Springs, AR 71913
Phone (501) 622-6556

1 Mercy Ln
Ste 201
Hot Springs National Park, AR 71913
Phone (501) 321-2229

1 Mercy Ln
Ste 404
Hot Springs National Park, AR 71913
Phone (501) 321-1026

16221 Saint Vincent Way
Little Rock, AR 72223
Phone (501) 221-0888

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

500 S University Ave
Ste 101
Little Rock, AR 72205
Phone (501) 686-2688

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.

Hospital & facility affiliations 12

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1063973618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE STE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055314",
            "telephone_number": "501-664-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE STE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055314",
            "telephone_number": "501-664-3914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMORAN",
        "first_name": "ETHAN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-27",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "AR",
            "license": "E-18922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.