Individual provider Active NPI

John Gary Tharp, M.D.

  • Specialist
  • Little Rock, AR
National Provider Identifier
1083675441
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C8184 Issued in AR
Practice address
1501 Aldersgate Rd
Little Rock, AR 72205-6611
Phone
(501) 228-9393
Fax
(501) 228-6019
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X C8184 AR Primary

Addresses

Primary practice location

1501 Aldersgate Rd
Little Rock, AR 72205-6611

Mailing address

1501 Aldersgate Rd
Little Rock, AR 72205-6611
Phone (501) 228-9393

Other identifiers 1

IdentifierTypeStateIssuer
124952001MedicaidAR

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20051027000639 AR Practitioner - NeurologyPractitioner - PsychiatryPractitioner - Addiction Medicine 8729971825 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C8184ARMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Uhs of Benton, LLC CurrentSince Jan 1, 2006 Accepting new patients
Habilitation Center, LLC Past Accepting new patients
Habilitation Center, LLC Past Accepting new patients

Locations

100 Rivendell Dr
Benton, AR 72019
Phone (501) 316-1255

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083675441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 ALDERSGATE RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056611",
            "telephone_number": "501-228-9393",
            "fax_number": "501-228-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 ALDERSGATE RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056611",
            "telephone_number": "501-228-9393",
            "fax_number": "501-228-6019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THARP",
        "first_name": "JOHN",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AR",
            "license": "C8184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124952001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.