NPIMap

Individual provider Active NPI

Autumn Leigh Wyeth, D.O.

  • Anatomic Pathology & Clinical Pathology Physician
  • Little Rock, AR
National Provider Identifier
1265896203
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
E-12805 Issued in AR
Practice address
4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone
(501) 686-8000
Fax
(501) 526-5148
NPI assigned
Apr 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X E-12805 AR Primary

Addresses

Primary practice location

4301 W Markham St # 783
Little Rock, AR 72205-7101

Mailing address

4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other practice location 1

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

Other names 1

  • Autumn Allison Former name

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
I20200810000115 AR Practitioner - Pathology 8224320569 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Oklahoma State University College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Pathology Associates PAGroup PAC ID 8921905589, 10 clinicians

Practice addresses (Care Compare)

1000 N University Ave
Little Rock, AR 72207-6347
Phone (501) 663-4116

Hospital & facility affiliations

  • CHI-St Vincent Infirmary Hospital, Little Rock, AR, CCN 040007
  • CHI St. Vincent Hospital Hot Springs Hospital, Hot Springs, AR, CCN 040026
  • Saline Memorial Hospital Hospital, Benton, AR, CCN 040084
  • Conway Regional Medical Center, Inc Hospital, Conway, AR, CCN 040029
  • Arkansas Surgical Hospital Hospital, No Little Rock, AR, CCN 040147

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Childrens Hospital CurrentSince Jul 1, 2020 Accepting new patients
Arkansas Pathology Associates PA Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2021 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2020 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
Arkansas Children'S Hospital CurrentSince Jul 1, 2020 Accepting new patients

Locations

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

1 Childrens Way
Ste 653
Little Rock, AR 72202

1000 N University Ave
Little Rock, AR 72207
Phone (501) 661-0060

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

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

4301 W Markham St
#517
Little Rock, AR 72205
Phone (501) 603-1508

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

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

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 and National Provider Directory roles.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1265896203",
    "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": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Childrens Way # 653",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722023500",
            "country_code": "US",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYETH",
        "first_name": "AUTUMN",
        "middle_name": "LEIGH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-06",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AR",
            "license": "E-12805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUTUMN",
            "last_name": "ALLISON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.