Active NPI
Sandra Lynn Withers
- Pediatric Nurse Practitioner
- Little Rock, AR
National Provider Identifier
1215196068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- A01053ANP
- Practice address
- 800 Marshall St
Kids First, Ach, Slot 900
Little Rock, AR 72202-3510 - Phone
- (501) 364-6594
- NPI assigned
- Jun 6, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | A01053ANP | AR | Primary |
Addresses
Primary practice location
800 Marshall St
Kids First, Ach, Slot 900
Little Rock, AR 72202-3510
Mailing address
800 Marshall St
Kids First, Ach Slot 900
Little Rock, AR 72202-3510
Phone (501) 364-6594
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
| License | State | Type | Specialty |
|---|---|---|---|
| A01053ANP | AR | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212710400000",
"number": "1215196068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 MARSHALL ST",
"address_2": "KIDS FIRST, ACH SLOT 900",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722023510",
"telephone_number": "501-364-6594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 MARSHALL ST",
"address_2": "KIDS FIRST, ACH, SLOT 900",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722023510",
"telephone_number": "501-364-6594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITHERS",
"first_name": "SANDRA",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-06",
"last_updated": "2008-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "AR",
"license": "A01053ANP",
"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 Jun 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.