NPIMap

Organization Active NPI

University of Arkansas for Medical Sciences

Doing business as SW Community Clinic

  • Adolescent Medicine (Family Medicine) Physician
  • Little Rock, AR
National Provider Identifier
1285307744
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X
Legal business name
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Doing business as
SW Community Clinic
Practice address
9015 Dailey Dr
Little Rock, AR 72209-6215
Phone
(501) 364-6560
Fax
(501) 364-4020
NPI assigned
Jul 29, 2021
Last updated
Jul 29, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Authorized official

Name
Amanda D George
Title
Vice Chancellor-Chief Financial Off
Phone
(501) 686-5670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0000X Primary

Addresses

Primary practice location

9015 Dailey Dr
Little Rock, AR 72209-6215

Mailing address

9015 Dailey Dr
Little Rock, AR 72209-6215
Phone (501) 364-6560

Other names 1

  • SW Community Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040115000431 AR Part B Supplier - Clinic/Group Practice 4082528955 Receives reassigned benefits from 1,297 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Little Rock, AR

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Hope Hartz111 organizations share this tax ID, including this one
Part of
Hope Hartz

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

9015 Dailey Dr
Little Rock, AR 72209
Phone (501) 364-6560

Practitioners & affiliated clinicians

Practitioners 65

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1285307744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9015 DAILEY DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722096215",
            "telephone_number": "501-364-6560",
            "fax_number": "501-364-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9015 DAILEY DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722096215",
            "telephone_number": "501-364-6560",
            "fax_number": "501-364-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE CHANCELLOR-CHIEF FINANCIAL OFF",
        "authorized_official_telephone_number": "501-686-5670"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SW Community Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.