Active NPI
Bib, LLC
- Body Imaging Physician
- Little Rock, AR
National Provider Identifier
1366489247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Body Imaging Physician
- Legal business name
- BIB, LLC
- Doing business as
- Baptist Health Imaging Center-Saline County
- Practice address
- 11001 Executive Center Dr
Suite 200
Little Rock, AR 72211-4316 - Phone
- (501) 812-7587
- Fax
- (501) 812-7588
- NPI assigned
- Jun 1, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Mike Todd Heck
- Title
- Chairman of the Board
- Phone
- (501) 202-4000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | Primary |
Addresses
Primary practice location
11001 Executive Center Dr
Suite 200
Little Rock, AR 72211-4316
Mailing address
829 W Carpenter St
Benton, AR 72015-3349
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 161373002 | Medicaid | AR |
Other names 1
- Baptist Health Imaging Center-Saline County
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060623000236 | AR | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 9032121645 | Practice locations: Benton, AR |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
829 W Carpenter St
Benton, AR 72015
Phone (501) 219-1114
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Diagnostic Radiology Physician
- Little Rock, AR
- NPI 1508032988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1212537600000",
"number": "1366489247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "829 W CARPENTER ST",
"city": "BENTON",
"state": "AR",
"postal_code": "720153349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11001 EXECUTIVE CENTER DR",
"address_2": "SUITE 200",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722114316",
"telephone_number": "501-812-7587",
"fax_number": "501-812-7588"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BIB, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-01",
"last_updated": "2008-06-04",
"status": "A",
"authorized_official_last_name": "HECK",
"authorized_official_first_name": "MIKE",
"authorized_official_middle_name": "TODD",
"authorized_official_title_or_position": "CHAIRMAN OF THE BOARD",
"authorized_official_telephone_number": "501-202-4000",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Body Imaging",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "161373002",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Baptist Health Imaging Center-Saline County",
"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 Jun 4, 2008; 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.