Individual provider Active NPI

Ijanae Holman-Allgood, MD

  • Family Medicine Physician
  • North Little Rock, AR
National Provider Identifier
1356978142
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-16169 Issued in AR
Practice address
4625 John F Kennedy Blvd
North Little Rock, AR 72116-7310
Phone
(501) 435-3455
Fax
(501) 483-3630
NPI assigned
Mar 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-16169 AR Primary

Addresses

Primary practice location

4625 John F Kennedy Blvd
North Little Rock, AR 72116-7310

Mailing address

4625 JFK Blvd
North Little Rock, AR 72116-7310
Phone (501) 435-3455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, AR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231110000518 NM Practitioner - Family Practice 2466809512 Reassigns benefits to 2 organizations
I20241021002142 AR Practitioner - Family Practice 2466809512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

4625 John F Kennedy Blvd
North Little Rock, AR 72116-7310
Phone (501) 435-3455

Hospital & facility affiliations

  • Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-16169ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de Familia, Incorporated CurrentSince Sep 25, 2023 Accepting new patients
PHC-Las Cruces Inc Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Arkansas Health Group CurrentSince Oct 21, 2024 Accepting new patients
La Clinica de Familia, Incorporated Current Accepting new patients
PHC Las Cruces Inc CurrentSince Aug 1, 2023 Accepting new patients
Arkansas Health Group CurrentSince Oct 21, 2024 Accepting new patients
La Clinica de Familia, Incorporated CurrentSince Sep 25, 2023 Accepting new patients
Arkansas Health Group Family Medicine Past Accepting new patients
PHC-Las Cruces Inc Past Accepting new patients

Locations

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

3201 Springhill Dr
Ste 130
North Little Rock, AR 72117
Phone (501) 955-2741

4625 John F Kennedy Blvd
North Little Rock, AR 72116
Phone (501) 435-3455

826 Anthony Dr
Anthony, NM 88021
Phone (575) 201-5135

385 Calle de Alegra
Bldg A
Las Cruces, NM 88005
Phone 57552611052444

575 S Alameda Blvd
Las Cruces, NM 88005
Phone (575) 528-6400

2450 S Telshor Blvd
Ste B
Las Cruces, NM 88011
Phone (575) 556-5800

2450 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-8641

Interoperability endpoints

  • Direct secure messaging: iholmanallgood758428@direct.baptist-healthar.org
  • Direct secure messaging: ijanae.holman.allgood.1@19849.direct.athenahealth.com

Organizations & group practices 9

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 1

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": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1356978142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 JFK BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721167310",
            "telephone_number": "501-435-3455",
            "fax_number": "501-483-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 JOHN F KENNEDY BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721167310",
            "telephone_number": "501-435-3455",
            "fax_number": "501-483-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN-ALLGOOD",
        "first_name": "IJANAE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-16169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.