Active NPI
Lawrence Monroe George, M.D.
- Surgery Physician
- Berryville, AR
National Provider Identifier
1073548855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- E-3465
- Practice address
- 211 Carter St
Berryville, AR 72616-4303 - Phone
- (870) 423-3338
- Fax
- (870) 423-7330
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | E-3465 | AR | Primary |
Addresses
Primary practice location
211 Carter St
Berryville, AR 72616-4303
Mailing address
PO Box 505164
Saint Louis, MO 63150-5164
Phone (417) 829-4620
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E-3465 | Other | AR | LICENSE |
| 5M428 | Other | AR | AR BLUE SHIELD # |
| 126625001 | Medicaid | AR | |
| 208778200 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-3465 | AR | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Anthony'S Hospital Association | Past | Accepting new patients | |
| Correct Care, Inc. | Past | Accepting new patients | |
| National Healthcare of Newport Inc | Past | Accepting new patients | |
| St. Anthony'S Hospital Association | Past | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Organizations & group practices 5
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.
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- NPI 1386796670
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-
- General Acute Care Hospital
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412208000000",
"number": "1073548855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 505164",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631505164",
"telephone_number": "417-829-4620",
"fax_number": "417-829-4316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 CARTER ST",
"city": "BERRYVILLE",
"state": "AR",
"postal_code": "726164303",
"telephone_number": "870-423-3338",
"fax_number": "870-423-7330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEORGE",
"first_name": "LAWRENCE",
"middle_name": "MONROE",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2014-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AR",
"license": "E-3465",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "E-3465",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AR BLUE SHIELD #",
"identifier": "5M428",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "126625001",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "208778200",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Berryville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.