Izoumroud Osmanovna Soultanova, MD, PH.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E-6465 Issued in AR

Practice address

11912 Kanis Rd Ste F2
Little Rock, AR 72211-3771

Phone

(501) 227-8020

NPI assigned

Aug 28, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Bridgeway LLCGroup PAC ID 7113819376, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elite Home Health Home health agency, Little Rock, AR, CCN 047028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16686/brand/1/csg/1/fhir/r4

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.

• The Bridgeway, LLC

  • Psychiatric Hospital
  • North Little Rock, AR
  • NPI 1962473306
  Medicare reassignment Care Compare group NPD
• Saline Clinics LLC

  • Gastroenterology Physician
  • Benton, AR
  • NPI 1447609367

  Family Medicine

  Medicare reassignment NPD

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

• LHCG Xlii, LLC

  • Home Health Agency
  • Little Rock, AR
  • NPI 1447597182
  Care Compare affiliation

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1265626790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11912 KANIS RD STE F2",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113771",
            "telephone_number": "501-227-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11912 KANIS RD STE F2",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113771",
            "telephone_number": "501-227-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOULTANOVA",
        "first_name": "IZOUMROUD",
        "middle_name": "OSMANOVNA",
        "credential": "MD, PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-6465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183018001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ricardo Federico Sotomora, M.D.
• Hannah L Soucy, APRN
• Gary T. Souheaver, PH.D.
• Jessica Leigh Soule, LCSW
• Neil Soules
• Soulutions Therapy and Coaching Services LLC
• South Central Medical Services, P.a.
• Abigail Washispack Southard, MD
• Lisa K Southerland
• Southern Carrier Services

• Family Medicine Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.