NPIMap

Individual provider Active NPI

Shane J Tharp, MD

  • Diagnostic Radiology Physician
  • Little Rock, AR
National Provider Identifier
1104878420
Registry record updated Nov 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
E3435 Issued in AR
Practice address
500 South University Ave
Suite 101
Little Rock, AR 72205-5314
Phone
(501) 664-3914
Fax
(501) 664-5246
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X E3435 AR Primary

Addresses

Primary practice location

500 South University Ave
Suite 101
Little Rock, AR 72205-5314

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
161721001MedicaidAR

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
I20060819000006 AR Practitioner - Diagnostic Radiology 2668475385 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Arkansas College of Medicine, 2001
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
E3435ARMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group Diagnostic Radiology CurrentSince Aug 8, 2011 Accepting new patients
CHI St. Vincent Medical Group Hot Springs CurrentSince Jun 1, 2025 Accepting new patients
Radiology Associates PA Diagnostic Radiology CurrentSince Jul 1, 2006 Accepting new patients
Pinnacle Radiology PLLC Diagnostic Radiology PastSince Oct 25, 2020 Accepting new patients

Locations

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

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

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

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 4

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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384819200000",
    "number": "1104878420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SOUTH UNIVERSITY AVE",
            "address_2": "SUITE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055314",
            "telephone_number": "501-664-3914",
            "fax_number": "501-664-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SOUTH UNIVERSITY AVE",
            "address_2": "SUITE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055314",
            "telephone_number": "501-664-3914",
            "fax_number": "501-664-5246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THARP",
        "first_name": "SHANE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2013-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AR",
            "license": "E3435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161721001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.