Organization Active NPI

Karl H. Landberg, M.D., P.a.

  • Gastroenterology Physician
  • Conway, AR
National Provider Identifier
1114254588
Registry record updated Nov 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
KARL H. LANDBERG, M.D., P.A.
Practice address
1375 Highway 64 W
Conway, AR 72032-2778
Phone
(501) 336-9620
Fax
(501) 336-0018
NPI assigned
Nov 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2009

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

Authorized official

Name
Dr. Karl H Landberg, M.D.NPI 1265493241
Title
Owner
Phone
(501) 336-9620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

1375 Highway 64 W
Conway, AR 72032-2778

Mailing address

1375 Highway 64 W
Conway, AR 72032-2778
Phone (501) 336-9620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091215000602 AR Part B Supplier - Clinic/Group Practice 2961542345 Receives reassigned benefits from 1 practitioner
Practice locations: Conway, AR

National Provider Directory

National Provider Directory

Locations

1375 Highway 64 W
Conway, AR 72032
Phone (501) 336-9620

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257379200000",
    "number": "1114254588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 HIGHWAY 64 W",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720322778",
            "telephone_number": "501-336-9620",
            "fax_number": "501-336-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 HIGHWAY 64 W",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720322778",
            "telephone_number": "501-336-9620",
            "fax_number": "501-336-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KARL H. LANDBERG, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-05",
        "last_updated": "2009-11-05",
        "status": "A",
        "authorized_official_last_name": "LANDBERG",
        "authorized_official_first_name": "KARL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-336-9620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.