Individual provider Active NPI

Eddy Lloyd Caldwell, DPM

  • Podiatrist
  • Jonesboro, AR
National Provider Identifier
1235131640
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
AR-163 Issued in AR
Practice address
406 E Washington Ave
Jonesboro, AR 72401-3108
Phone
(870) 933-8900
Fax
(870) 933-2611
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X AR-163 AR Primary

Addresses

Primary practice location

406 E Washington Ave
Jonesboro, AR 72401-3108

Mailing address

PO Box 1984
Jonesboro, AR 72403-1984
Phone (870) 933-8900

Other identifiers 5

IdentifierTypeStateIssuer
130246748OtherARCLINIC NUMBER
167681748OtherARMEDICAID CLINIC
130109717MedicaidAR
5T344F963OtherARMEDICARE CLLINIC
480034780OtherARRR MEDICARE

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080501000715 AR Practitioner - Podiatry 8123107141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foot Care of Northeast Arkansas, PAGroup PAC ID 0143309153, 2 clinicians

Practice addresses (Care Compare)

801 Osler Dr
Suite D
Jonesboro, AR 72401-4329
Phone (870) 933-8900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue48
Removal of skin lesions44
Removal of nail tissue562
Removal or shaving of skin growth186

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AR-163ARMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot Care of Northeast Arkansas PA Podiatrist CurrentSince Aug 1, 1996 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1100 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 935-8500

406 E Washington Ave
Jonesboro, AR 72401
Phone (866) 763-3044

801 Osler Dr
Ste D
Jonesboro, AR 72401
Phone (870) 336-3366

912 Osler Dr
Ste B
Jonesboro, AR 72401
Phone (870) 933-8900

Organizations & group practices 2

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1235131640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1984",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724031984",
            "telephone_number": "870-933-8900",
            "fax_number": "870-933-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 E WASHINGTON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013108",
            "telephone_number": "870-933-8900",
            "fax_number": "870-933-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "EDDY",
        "middle_name": "LLOYD",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AR",
            "license": "AR-163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC NUMBER",
            "identifier": "130246748",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CLINIC",
            "identifier": "167681748",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130109717",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CLLINIC",
            "identifier": "5T344F963",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "480034780",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.