Carson Wataru Ercanbrack

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

3700 Old Cantrell Rd Apt 412
Little Rock, AR 72202-1967

Phone

(480) 389-7419

NPI assigned

Jul 27, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1722038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722038400000",
    "number": "1235968470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 OLD CANTRELL RD APT 412",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722021967",
            "telephone_number": "480-389-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 OLD CANTRELL RD APT 412",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722021967",
            "telephone_number": "480-389-7419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERCANBRACK",
        "first_name": "CARSON",
        "middle_name": "WATARU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-27",
        "last_updated": "2024-07-27",
        "certification_date": "2024-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Epic Medical Supplies, Inc.
• Epoch Health
• Epoch Health- Little Rock, PLLC
• Stephen Nathaniel Epps, MD
• Marcia Louise Erbland, MD
• April Gulay Erdag, MD
• Eren Erdem, MD
• Angela M. Ergle, PHARM. D.
• Eric Gormley LLC
• Erick Messias MD PLLC

• Student in an Organized Health Care Education/Training Program in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Student in an Organized Health Care Education/Training Program in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.