Active NPI
Geoffrey Thomas Halversen
- Dentist
- Little Rock, AR
National Provider Identifier
1295584092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4799
- Practice address
- 5 Allied Dr
Little Rock, AR 72202-2013 - Phone
- (501) 437-8911
- NPI assigned
- May 14, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4799 | AR | Primary |
Addresses
Primary practice location
5 Allied Dr
Little Rock, AR 72202-2013
Mailing address
221 Meadow LN
Madison, IN 47250-2511
Phone (812) 599-5295
Medicare participation
Medicare enrollment files- 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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240701001532 | AR | Order and Referring Only - Dentist | 3274077391 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4799 | AR | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754697600000",
"number": "1295584092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 MEADOW LN",
"city": "MADISON",
"state": "IN",
"postal_code": "472502511",
"telephone_number": "812-599-5295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 ALLIED DR",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722022013",
"telephone_number": "501-437-8911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALVERSEN",
"first_name": "GEOFFREY",
"middle_name": "THOMAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-05-14",
"last_updated": "2025-08-09",
"certification_date": "2025-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "4799",
"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 9, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.