NPIMap

Individual provider Active NPI

Robert J Wilkerson, M.D.

  • Internal Medicine Physician
  • Morrilton, AR
National Provider Identifier
1245322387
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C-5596 Issued in AR
Practice address
#10 Hospital Drive
Morrilton, AR 72110
Phone
(501) 354-0052
Fax
(501) 354-9142
NPI assigned
Sep 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C-5596 AR Primary

Addresses

Primary practice location

#10 Hospital Drive
Morrilton, AR 72110

Mailing address

#10 Hospital Drive
Morrilton, AR 72110
Phone (501) 354-0052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060130000912 AR Practitioner - Internal Medicine 2961493143 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arkansas College of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morrilton Medical Clinic, P.a.Group PAC ID 2860482130, 8 clinicians
St Anthonys Hospital AssociationGroup PAC ID 4082516554, 10 clinicians

Practice addresses (Care Compare)

10 Hospital Dr
Morrilton, AR 72110-4510
Phone (501) 354-0052

4 Hospital Dr
Morrilton, AR 72110-4510
Phone (501) 977-2300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C-5596ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morrilton Medical Clinic, P.a. CurrentSince Oct 1, 1986 Accepting new patients
Morrilton Medical Clinic, P.a. Internal Medicine CurrentSince Oct 1, 1986 Accepting new patients
St. Anthony's Hospital Association Internal Medicine Current Accepting new patients
St. Anthony's Hospital Association Past Accepting new patients

Locations

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

10 Hospital Dr
Morrilton, AR 72110
Phone (501) 354-0052

4 Hospital Dr
Morrilton, AR 72110
Phone (501) 977-2300

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Morrilton Medical Clinic, P.a.Morrilton, AR, CCN 043878 Rural health clinic 5% Or Greater Direct Ownership Interest (16.66%)
Corporate Officer (16.66%)		 Dec 4, 1984
Dec 4, 1984

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245322387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "#10 HOSPITAL DRIVE",
            "city": "MORRILTON",
            "state": "AR",
            "postal_code": "72110",
            "telephone_number": "501-354-0052",
            "fax_number": "501-354-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#10 HOSPITAL DRIVE",
            "city": "MORRILTON",
            "state": "AR",
            "postal_code": "72110",
            "telephone_number": "501-354-0052",
            "fax_number": "501-354-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "C-5596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrilton, AR

Sources for this page

Verify at the official NPI Registry.