NPIMap

Organization Active NPI

Little Rock Internal Medicine

  • Internal Medicine Physician
  • Little Rock, AR
National Provider Identifier
1285774059
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LITTLE ROCK INTERNAL MEDICINE
Practice address
5918 Lee Ave
Little Rock, AR 72205-3326
Phone
(501) 224-1690
Fax
(501) 224-1927
NPI assigned
Feb 8, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Lisa A Childers
Title
Credentialing
Phone
(501) 224-1690

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

5918 Lee Ave
Little Rock, AR 72205-3326

Mailing address

5918 Lee Ave
Little Rock, AR 72205-3326
Phone (501) 224-1690

National Provider Directory

National Provider Directory
Tax ID family
Catholic Health Initiatives -St Vincent Interfaith Clinic Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285774059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5918 LEE AVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053326",
            "telephone_number": "501-224-1690",
            "fax_number": "501-224-1927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5918 LEE AVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053326",
            "telephone_number": "501-224-1690",
            "fax_number": "501-224-1927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE ROCK INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHILDERS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "501-224-1690"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.