Andrea Green Mabry, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

E-8321 Issued in AR

Practice address

16115 Saint Vincent Way
Suite 300
Little Rock, AR 72223-3000

Phone

(501) 420-3376

Fax

(501) 817-3930

NPI assigned

Apr 16, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Mississippi Medical College, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prime Medical Group PLLCGroup PAC ID 1153753520, 17 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Prime Medical Group PLLC

  • Dermatology Physician
  • Little Rock, AR
  • NPI 1427605153

  AR, Dermatology

  Medicare reassignment Care Compare group NPD
• Arkansas Family Care Network

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1336396407
  NPD (past)

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467849600000",
    "number": "1366709255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16115 SAINT VINCENT WAY",
            "address_2": "SUITE 300",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722233000",
            "telephone_number": "501-420-3376",
            "fax_number": "501-817-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16115 SAINT VINCENT WAY",
            "address_2": "SUITE 300",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722233000",
            "telephone_number": "501-420-3376",
            "fax_number": "501-817-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABRY",
        "first_name": "ANDREA",
        "middle_name": "GREEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-16",
        "last_updated": "2016-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AR",
            "license": "E-8321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William H Maack III, ATC, CSCS
• Mehrnoosh Maalhaghfard
• Nancy Maalouf, M.D.
• William Thomas Mabrey, M.D.
• Allison Mabry, AU.D.
• Mary Anne Mabry, OTR/L
• Vicki Lynn Mabry, APN
• Kimberly T. Macconaugha, APN
• Greta M Macdonald, APRN
• Billy Randall Machen, DDS PA

• All providers in Little Rock, AR
• Dermatology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.