NPIMap

Individual provider Active NPI

Ali Rene Mitchell, DO

  • Family Medicine Physician
  • Arkadelphia, AR
National Provider Identifier
1295398865
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-15636 Issued in AR
Practice address
2913 Cypress Rd Ste 100
Arkadelphia, AR 71923-4251
Phone
(870) 246-2471
Fax
(870) 246-2476
NPI assigned
Apr 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X E-15636 AR Primary

Addresses

Primary practice location

2913 Cypress Rd Ste 100
Arkadelphia, AR 71923-4251

Mailing address

11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (870) 246-2471

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
I20220803002765 AR Practitioner - Family Practice 5496088403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
William Carey University College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist HealthGroup PAC ID 0648177949, 106 clinicians

Practice addresses (Care Compare)

2913 Cypress Rd
Suite 100
Arkadelphia, AR 71923-4251
Phone (870) 246-2471

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Current Accepting new patients
Baptist Health Family Medicine CurrentSince Aug 15, 2022 Accepting new patients
Baptist Health CurrentSince Aug 15, 2022 Accepting new patients
Baptist Health Past Accepting new patients

Locations

2913 Cypress Rd
Ste 100
Arkadelphia, AR 71923
Phone (870) 246-2471

10 Montgomery Dr
Caddo Valley, AR 71923
Phone (870) 245-2198

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

3333 Springhill Dr
North Little Rock, AR 72117
Phone (501) 202-3000

Interoperability endpoints

  • Direct secure messaging: amitchell342951@direct.baptist-healthar.org

Organizations & group practices 4

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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1295398865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "870-246-2471",
            "fax_number": "870-246-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2913 CYPRESS RD STE 100",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719234251",
            "telephone_number": "870-246-2471",
            "fax_number": "870-246-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "ALI",
        "middle_name": "RENE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-15636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arkadelphia, AR

Sources for this page

Verify at the official NPI Registry.