Solomon C Mogbo, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

E1875 Issued in AR

Practice address

1401 Kanis Park Dr
Ste 200
Little Rock, AR 72205-4571

Phone

(501) 537-4590

Fax

(501) 537-4591

NPI assigned

Aug 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: smogbo2698@direct.baptist-healthar.org

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.

• Arkansas Internal Medicine Clinic PA

  • Specialist
  • Little Rock, AR
  • NPI 1821117565
  Medicare reassignment Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Health

  dba Baptist Health Medical Center-Little Rock

  • General Acute Care Hospital
  • Little Rock, AR
  • NPI 1043240682
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1083615348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 KANIS PARK DR",
            "address_2": "STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054571",
            "telephone_number": "501-537-4590",
            "fax_number": "501-537-4591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 KANIS PARK DR",
            "address_2": "STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054571",
            "telephone_number": "501-537-4590",
            "fax_number": "501-537-4591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGBO",
        "first_name": "SOLOMON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E1875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145707001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFCATION",
            "identifier": "912187095",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smogbodr@arinternalmedicineclinic.direct.edms.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1401 KANIS PARK DR",
            "address_2": "STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "country_code": "US",
            "postal_code": "722054571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pooja Modi
• Anne Moellers
• Angie Moench, RT
• Kelly Moffett Place, LPC
• Thomas Robert Moffett Jr., MD
• Kevin Todd Mogish, MHPP
• Ayman Zakaria Ahmed Mohamed, MD
• Mazar Mohamed Yousif Mohamed, MD
• Amr Mohammed, MD
• Bhavesh Mohan Lal

• Internal Medicine Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Internal Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.