NPIMap

Individual provider Active NPI

Patrick Lee Fraley, M.D.

  • Otolaryngology Physician
  • Conway, AR
National Provider Identifier
1376623165
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
E-5994 Issued in AR
Practice address
2425 Dave Ward Dr Ste 1101
Conway, AR 72034-8686
Phone
(501) 932-7600
Fax
(501) 932-7603
NPI assigned
Oct 16, 2006
Last updated
Oct 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 2004014126 MO
Otolaryngology Physician 207Y00000X E-5994 AR Primary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X E-5994 AR

Addresses

Primary practice location

2425 Dave Ward Dr Ste 1101
Conway, AR 72034-8686

Mailing address

PO Box 251420
Little Rock, AR 72225-1420
Phone (501) 686-8000

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
I20090727000448 AR Practitioner - Otolaryngology 9032262837 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Arkansas College of Medicine, 2004
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)

4301 W Markam St
Little Rock, AR 72205-7101
Phone (501) 686-8000

9800 Baptist Health Dr
Suite 400
Little Rock, AR 72205-6238
Phone (501) 202-4630

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-5994ARMDOtolaryngology Physician
2004014126MOMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Aug 1, 2021 Accepting new patients
Arkansas Health Group Otolaryngology CurrentSince Apr 29, 2024 Accepting new patients
University of Arkansas for Medical Sciences Otolaryngology Current Accepting new patients
University of Arkansas for Medical Science Otolaryngology CurrentSince Aug 8, 2021 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Aug 1, 2021 Accepting new patients
Arkansas Health Group CurrentSince Apr 29, 2024 Accepting new patients

Locations

2425 Dave Ward Dr
Ste 101
Conway, AR 72034
Phone (501) 932-7600

2425 Dave Ward Dr
Ste 1101
Conway, AR 72034
Phone (501) 932-7600

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

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

9500 Kanis Rd
Ste 410
Little Rock, AR 72205
Phone (501) 202-1500

9800 Baptist Health Dr
Ste 400
Little Rock, AR 72205
Phone (501) 202-4630

Interoperability endpoints

  • Direct secure messaging: pfraley5206@direct.baptist-healthar.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1376623165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251420",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722251420",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 DAVE WARD DR STE 1101",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720348686",
            "telephone_number": "501-932-7600",
            "fax_number": "501-932-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRALEY",
        "first_name": "PATRICK",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "2004014126",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AR",
            "license": "E-5994",
            "primary": true
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "AR",
            "license": "E-5994",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.