Individual provider Active NPI

Zachary Walker Tilley, MD

  • Internal Medicine Physician
  • Little Rock, AR
National Provider Identifier
1144726993
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E-14274 Issued in AR
Practice address
4301 W Markham St # 641
Little Rock, AR 72205-7101
Phone
(501) 526-1010
NPI assigned
Apr 2, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-14274 AR Primary

Addresses

Primary practice location

4301 W Markham St # 641
Little Rock, AR 72205-7101

Mailing address

PO Box 251420
Little Rock, AR 72225-1420
Phone (501) 686-8000

Other practice location 1

2 Saint Vincent Cir
Little Rock, AR 72205-5423
Phone (501) 552-4677

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
I20210709000955 AR Practitioner - HospitalistPractitioner - Internal Medicine 6305192980 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
University of Arkansas College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical GroupGroup PAC ID 5698758803, 237 clinicians

Practice addresses (Care Compare)

2 Saint Vincent Cir
Little Rock, AR 72205-5423
Phone (501) 552-4666

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
University of Arkansas for Medical Sciences Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2021 Accepting new patients
St Vincent Physician Clinics LLC Past Accepting new patients

Locations

1811 Rahling Rd
Ste 120
Little Rock, AR 72223
Phone (501) 214-2360

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

4301 W Markham St
#641
Little Rock, AR 72205
Phone (501) 526-1010

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

16221 Saint Vincent Way
Little Rock, AR 72223
Phone (501) 221-0888

4301 W Markham St
#634
Little Rock, AR 72205
Phone (501) 686-5162

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

2215 Wildwood Ave
Sherwood, AR 72120
Phone (501) 522-7100

Organizations & group practices 4

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1144726993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251420",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722251420",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 641",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-526-1010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Saint Vincent Cir",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722055423",
            "country_code": "US",
            "telephone_number": "501-552-4677",
            "fax_number": "501-552-4555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILLEY",
        "first_name": "ZACHARY",
        "middle_name": "WALKER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-14274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.