Living Tree Pediatrics, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

E7529 Issued in AR

Legal business name

LIVING TREE PEDIATRICS, PLLC

Practice address

1110 SE 30TH Street
Bentonville, AR 72712-4290

Phone

(479) 282-2966

Fax

(479) 282-2967

NPI assigned

Jan 18, 2016

Last updated

Mar 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Julie Lynette Tate, M.D.NPI 1578731154

Title

Co-Owner

Phone

(479) 282-2966

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Julie Lynette Tate, M.D.

  • Pediatrics Physician
  • Bentonville, AR
  • NPI 1578731154
  NPD Authorized official
• Hanna Kathryn Baxendale, APRN

  • Pediatrics Physician
  • Bentonville, AR
  • NPI 1649803552
  NPD
• Shon Lindsay Moudy, APRN

  • Pediatric Nurse Practitioner
  • Bentonville, AR
  • NPI 1861005860
  NPD
• Bridgette Michelle Noble, DO

  • Pediatrics Physician
  • Bentonville, AR
  • NPI 1336725142
  NPD
• Jeffrey Allen Savage, M.D.

  • Pediatrics Physician
  • Bentonville, AR
  • NPI 1013139666
  NPD (past)

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

{
    "created_epoch": "1453075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647820800000",
    "number": "1396102679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2760",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124290",
            "telephone_number": "479-282-2966",
            "fax_number": "479-282-2967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 SE 30TH STREET",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124290",
            "telephone_number": "479-282-2966",
            "fax_number": "479-282-2967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING TREE PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-18",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A",
        "authorized_official_last_name": "TATE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "LYNETTE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "479-282-2966",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E7529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192425001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191183001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Linebaugh, MHPP/TEACHER
• Bethany Allison Link
• Meredith Hedberg Link, RD
• Stephanie Litzinger, LCSW
• Soudarath Liu, APRN
• Marissa B Livingston
• Tyler Brookes Lloyd, MD
• Emily Lock, OTD, OTR/L
• Donna Y Lockard, TEACHER/MHPP
• Saira Sole Lockett

• Pediatrics Physician in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Pediatrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.