NPIMap

Organization Active NPI

Arkansas Health Group

Doing business as Baptist Health Family Clinic - Rose City

  • Family Medicine Physician
  • North Little Rock, AR
National Provider Identifier
1114762085
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ARKANSAS HEALTH GROUP
Doing business as
Baptist Health Family Clinic - Rose City
Practice address
4200 East Washington Ave
North Little Rock, AR 72114-6463
Phone
(501) 534-1300
Fax
(501) 613-0848
NPI assigned
Jul 1, 2024
Last updated
Jul 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Authorized official

Name
Will Rusher
Title
Ceo
Phone
(501) 812-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

4200 East Washington Ave
North Little Rock, AR 72114-6463

Mailing address

11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (501) 534-1300

Other names 1

  • Baptist Health Family Clinic - Rose City Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120611000172 AR Part B Supplier - Clinic/Group Practice 7911802079 Receives reassigned benefits from 133 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: North Little Rock, AR; Stuttgart, AR; Russellville, AR; Monticello, AR; Little Rock, AR; Conway, AR

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2310061Baptist Health Family Clinic Rose City4200 East Washington Ave, North Little Rock, AR 72114Certificate of waiverAug 25, 2026

National Provider Directory

National Provider Directory
Tax ID family
Jeffrey S Mayfield49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

Organizations that report the same tax identification number in the National Provider Directory.

View all 48

Locations

4200 E Washington Ave
North Little Rock, AR 72114
Phone (501) 534-1300

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1114762085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "501-534-1300",
            "fax_number": "501-613-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 EAST WASHINGTON AVE",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721146463",
            "telephone_number": "501-534-1300",
            "fax_number": "501-613-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS HEALTH GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "RUSHER",
        "authorized_official_first_name": "WILL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "501-812-7500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Health Family Clinic - Rose City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.