NPIMap

Organization Active NPI

Full Potential

  • Pediatric Skilled Nursing Facility
  • Little Rock, AR
National Provider Identifier
1174891808
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X
License
L46656 Issued in AR
Legal business name
FULL POTENTIAL
Practice address
8109 Interstate 30
Little Rock, AR 72209
Phone
(501) 442-3268
NPI assigned
Dec 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Authorized official

Name
Mrs. Tanishia Marie Williams, LPN
Title
Nurse
Phone
(501) 442-3268

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Skilled Nursing Facility 3140N1450X L46656 AR Primary

Addresses

Primary practice location

8109 Interstate 30
Little Rock, AR 72209

Mailing address

P.O. Box 244
Mabelvale, AR 72103
Phone (501) 442-3268

National Provider Directory

National Provider Directory
Tax ID family
Full Potential4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323302400000",
    "number": "1174891808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 244",
            "city": "MABELVALE",
            "state": "AR",
            "postal_code": "72103",
            "telephone_number": "501-442-3268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8109 INTERSTATE 30",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72209",
            "telephone_number": "501-442-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL POTENTIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-08",
        "last_updated": "2011-12-08",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TANISHIA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "NURSE",
        "authorized_official_telephone_number": "501-442-3268",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "AR",
            "license": "L46656",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 8, 2011; 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.