NPIMap

Organization Active NPI

Little Rock Cardiology Clinic, PA

  • Cardiovascular Disease Physician
  • Little Rock, AR
National Provider Identifier
1124068556
Registry record updated Aug 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MC-0341 Issued in AR
Legal business name
LITTLE ROCK CARDIOLOGY CLINIC, PA
Practice address
7 Shackleford West Blvd
Little Rock, AR 72211-3714
Phone
(501) 664-5860
Fax
(501) 663-5017
NPI assigned
Jun 7, 2006
Last updated
Aug 28, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2009

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

Authorized official

Name
Mary J Middleton
Title
Assistant Executive Director
Phone
(501) 664-5860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MC-0341 AR Primary

Addresses

Primary practice location

7 Shackleford West Blvd
Little Rock, AR 72211-3714

Mailing address

7 Shackleford West Blvd
Little Rock, AR 72211-3714
Phone (501) 664-5860

Other identifiers 1

IdentifierTypeStateIssuer
104523002MedicaidAR

National Provider Directory

National Provider Directory

Locations

3020 E Woodson Lateral Rd
Hensley, AR 72065
Phone (501) 888-1541

1919 W Main St
Ste 2
Russellville, AR 72801
Phone (479) 967-6492

Practitioners & affiliated clinicians

Practitioners 46

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.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251417600000",
    "number": "1124068556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SHACKLEFORD WEST BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113714",
            "telephone_number": "501-664-5860",
            "fax_number": "501-663-5017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 SHACKLEFORD WEST BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113714",
            "telephone_number": "501-664-5860",
            "fax_number": "501-663-5017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE ROCK CARDIOLOGY CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2009-08-28",
        "status": "A",
        "authorized_official_last_name": "MIDDLETON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ASSISTANT EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "501-664-5860"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AR",
            "license": "MC-0341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104523002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.