Individual provider Active NPI

Caroline E Ruggles, PA

  • Physician Assistant
  • Little Rock, AR
National Provider Identifier
1215774609
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1294 Issued in AR
Practice address
4110 Outpatient Circle
Third Floor, Suite 3150
Little Rock, AR 72205
Phone
(501) 686-6918
Fax
(501) 686-8960
NPI assigned
Jul 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-1294 AR Primary

Addresses

Primary practice location

4110 Outpatient Circle
Third Floor, Suite 3150
Little Rock, AR 72205

Mailing address

4301 W Markham St # 783
Little Rock, AR 72205-7199

Other practice location 1

4301 W Markham St
Little Rock, AR 72205-7199
Phone (501) 686-7000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240925003748 AR Practitioner - Physician Assistant 3072054469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Arkansas for Medical SciencesGroup PAC ID 4082528955, 1,159 clinicians

Practice addresses (Care Compare)

4301 W Markam St
Little Rock, AR 72205-7101

Hospital & facility affiliations

  • University of Arkansas Medical Sciences Hospital, Little Rock, AR, CCN 040016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Aug 10, 2024 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Aug 10, 2024 Accepting new patients

Locations

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

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

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1215774609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 OUTPATIENT CIRCLE",
            "address_2": "THIRD FLOOR, SUITE 3150",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72205",
            "telephone_number": "501-686-6918",
            "fax_number": "501-686-8960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057199",
            "country_code": "US",
            "telephone_number": "501-686-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUGGLES",
        "first_name": "CAROLINE",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-1294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.