Individual provider Active NPI

Renee Bornemeier, MD

  • Pediatric Cardiology Physician
  • Little Rock, AR
National Provider Identifier
1104916600
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
C-7449 Issued in AR
Practice address
1 Childrens Way # 512-3
Little Rock, AR 72202-3500
Phone
(501) 364-1100
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X C-7449 AR Primary

Addresses

Primary practice location

1 Childrens Way # 512-3
Little Rock, AR 72202-3500

Mailing address

1 Childrens Way # 512-3
Little Rock, AR 72202-3500
Phone (501) 364-1479

Other identifiers 1

IdentifierTypeStateIssuer
125977001MedicaidAR

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
I20100319000834 AR Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 9133254857 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Pediatric Medicine
Education
University of Arkansas College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Childrens Professional Services Organization LLCGroup PAC ID 4688183148, 180 clinicians

Practice addresses (Care Compare)

1 Childrens Way
Little Rock, AR 72202-3500
Phone (501) 364-2526

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 1994 Accepting new patients
Arkansas Children'S Hospital CurrentSince Jul 1, 1994 Accepting new patients
Arkansas Childrens Professional Services Organization LLC CurrentSince Dec 31, 2025 Accepting new patients
Arkansas Childrens Hospital CurrentSince Jul 1, 1994 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 1994 Accepting new patients
University of Arkansas for Medical Sciences Pediatric Cardiology Current Accepting new patients
Arkansas Childrens Hospital Past Accepting new patients
Arkansas Childrens Hospital Past Accepting new patients

Locations

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
Ste 653
Little Rock, AR 72202

1 Childrens Way
#854
Little Rock, AR 72202

1 Childrens Way
#5123
Little Rock, AR 72202
Phone (501) 364-1479

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

800 Marshall St
Little Rock, AR 72202
Phone (501) 364-3620

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

Organizations & group practices 8

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284940800000",
    "number": "1104916600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 512-3",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 512-3",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORNEMEIER",
        "first_name": "RENEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2010-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "AR",
            "license": "C-7449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125977001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.