Individual provider Active NPI

L Daniel Eaton

  • Specialist
  • Little Rock, AR
National Provider Identifier
1154346294
Registry record updated Jan 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
84-189-08 Issued in AR
Practice address
220 N Van Buren St
Little Rock, AR 72205-3650
Phone
(501) 265-0100
Fax
(501) 265-0102
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 84-189-08 AR Primary

Addresses

Primary practice location

220 N Van Buren St
Little Rock, AR 72205-3650

Mailing address

220 N Van Buren St
Little Rock, AR 72205-3650
Phone (501) 265-0100

Other identifiers 4

IdentifierTypeStateIssuer
35217806300OtherARDME/QUALCHOICE
02593066MedicaidNY
140207716MedicaidAR
49597OtherARDME/BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
84-189-08ARMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Alloplastic Restoration Foundation, Inc. Current Accepting new patients

Locations

220 N Van Buren St
Little Rock, AR 72205
Phone (501) 265-0100

Organizations & group practices 1

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232582400000",
    "number": "1154346294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N VAN BUREN ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053650",
            "telephone_number": "501-265-0100",
            "fax_number": "501-265-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N VAN BUREN ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053650",
            "telephone_number": "501-265-0100",
            "fax_number": "501-265-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "L DANIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2009-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AR",
            "license": "84-189-08",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME/QUALCHOICE",
            "identifier": "35217806300",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02593066",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140207716",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME/BCBS",
            "identifier": "49597",
            "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 Jan 22, 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.