Little Rock Dermatology Clinic P.a.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

5C206 Issued in AR

Legal business name

LITTLE ROCK DERMATOLOGY CLINIC P.A.

Practice address

500 S University Ave
301
Little Rock, AR 72205-5302

Phone

(501) 664-4161

Fax

(501) 664-6108

NPI assigned

Dec 1, 2006

Last updated

Aug 31, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Marion Nixon

Title

Office Manager

Phone

(501) 664-4161

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 9

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.

• Matthew Kemp Kagy, MD

  • Dermatology Physician
  • Little Rock, AR
  • NPI 1467495101
  Medicare reassignment Care Compare group NPD
• Thomas Allen Manning III, MD

  • Dermatology Physician
  • Little Rock, AR
  • NPI 1447204490
  Medicare reassignment Care Compare group NPD
• Austin Grant Morgan, MD

  • Dermatology Physician
  • Little Rock, AR
  • NPI 1609456045
  Medicare reassignment Care Compare group NPD
• Brian Scott Wayne, M.D.

  • Dermatology Physician
  • Little Rock, AR
  • NPI 1275641169
  Medicare reassignment Care Compare group NPD
• Hailey M Arens, PA-C

  • Physician Assistant
  • Little Rock, AR
  • NPI 1700351376
  Medicare reassignment Care Compare group
• Alexandra Blue Sanroma, PA-C

  • Medical Physician Assistant
  • Little Rock, AR
  • NPI 1497128722
  Medicare reassignment Care Compare group
• Thomas Alan Jennings, M.D./PH.D.

  • Dermatology Physician
  • Sarasota, FL
  • NPI 1326365735

  AR

  Medicare reassignment Care Compare group
• Justin Michael McLawhorn, MD

  • MOHS-Micrographic Surgery Physician
  • Little Rock, AR
  • NPI 1316474471

  Dermatology

  Medicare reassignment NPD
• Burton Allan Moore, MD

  • Dermatology Physician
  • Little Rock, AR
  • NPI 1497798698
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314748800000",
    "number": "1215005731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE",
            "address_2": "301",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055302",
            "telephone_number": "501-664-4161",
            "fax_number": "501-664-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE",
            "address_2": "301",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055302",
            "telephone_number": "501-664-4161",
            "fax_number": "501-664-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE ROCK DERMATOLOGY CLINIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2011-08-31",
        "status": "A",
        "authorized_official_last_name": "NIXON",
        "authorized_official_first_name": "MARION",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "501-664-4161",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AR",
            "license": "5C206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Little Rock Community Mental Health Center
• Little Rock Community Mental Health Center Inc (Little Rock Community Mental Health Center)
• Little Rock Community Mental Health Center, Inc.
• Little Rock Counseling, PLC
• Little Rock Dentistry
• Little Rock Diagnostic Clinic PA
• Little Rock Diagnostic Clinic PA (Little Rock Diagnostic Clinic ASC)
• Little Rock Dialysis, Inc. (Little Rock Dialysis)
• Little Rock Endocrinology Services
• Little Rock Enrichment Center, Inc. (Adult Day Health Care)

• Dermatology Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Dermatology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.