Arkansas Health Group
Organization Active NPI Family Medicine Physician · Maumelle, AR
NPI 1124037866 · NPPES record last updated Apr 11, 2019
Key facts
- NPI
- 1124037866
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ARKANSAS HEALTH GROUP
- Practice address
- 1701 Club Manor Dr
Suite 2
Maumelle, AR 72113-7400 - Phone
- (501) 851-7400
- Fax
- (501) 851-4753
- NPI assigned
- Aug 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Will L Rusher
- Title
- Ceo
- Phone
- (501) 812-7500
Member of 2
Practitioners 4
-
Jalesia Austin, APRN
-
Rachael Constance Curtis, APRN-CNP, FNP-BC
-
Laura Farley, APRN
-
Fred G Nagel Jr., M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D0466687 | Baptist Health Family Clinic | Provider-performed microscopy | May 2, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051222000203 | AR | Part B Supplier - Clinic/Group Practice | 7911802079 |
Receives reassigned benefits from 4 practitioners Practice locations: Maumelle, AR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
1701 Club Manor Dr
Suite 2
Maumelle, AR 72113-7400
Mailing address
11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (501) 812-7215
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 129802002 | Medicaid | AR |
Other names
- Baptist Health Family Clinic Maumelle
Other providers in Maumelle, AR
- Arcare
- Ashlie Lemons Ardoin
- Arkansas Asthma & Lung Center Inc
- Arkansas Asthma & Lung Centers Inc
- Arkansas Back Clinic
- Arkansas Health Group
- Arkansas Health PLLC
- Arkansas Reliable Transportation LLC
- David Arnold
- Mary Helen Ashley
All providers in Maumelle, AR · Family Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.