NPIMap

Organization Active NPI

Arkansas Children's Medical Group PLLC

  • Pediatrics Physician
  • Little Rock, AR
National Provider Identifier
1396274841
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
ARKANSAS CHILDREN'S MEDICAL GROUP PLLC
Practice address
1 Childrens Way # 844
Little Rock, AR 72202-3500
Phone
(501) 364-2090
Fax
(501) 364-3929
NPI assigned
Jun 8, 2017
Last updated
Jul 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Authorized official

Name
Mr. Robert S Williams, MDNPI 1740369263
Title
President
Phone
(501) 364-2090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Pediatric Emergency Medicine (Pediatrics) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0204X
Pediatric Endocrinology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0205X
Pediatric Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0207X

Addresses

Primary practice location

1 Childrens Way # 844
Little Rock, AR 72202-3500

Mailing address

1 Childrens Way # 844
Little Rock, AR 72202-3500
Phone (501) 364-2090

Other practice location 1

2601 Gene George Blvd
Springdale, AR 72762-0845
Phone (479) 725-6801

Other practice location 2

1500 W 42nd Ave
Pine Bluff, AR 71603-7018
Phone (870) 341-5820

Other practice location 3

900 S 52nd St
Rogers, AR 72758-8637
Phone (479) 254-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171010002445 AR Part B Supplier - Clinic/Group Practice 7719252139 Receives reassigned benefits from 36 practitioners
Practice locations: Little Rock, AR; Pine Bluff, AR; Rogers, AR; Springdale, AR

National Provider Directory

National Provider Directory
Tax ID family
Arkansas Childrens Medical3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 68

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.

View all 68

NPI Registry JSON

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1396274841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 844",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-2090",
            "fax_number": "501-364-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 844",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-2090",
            "fax_number": "501-364-3929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 Gene George Blvd",
            "address_purpose": "LOCATION",
            "city": "Springdale",
            "state": "AR",
            "postal_code": "727620845",
            "country_code": "US",
            "telephone_number": "479-725-6801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 W 42nd Ave",
            "address_purpose": "LOCATION",
            "city": "Pine Bluff",
            "state": "AR",
            "postal_code": "716037018",
            "country_code": "US",
            "telephone_number": "870-341-5820",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 S 52nd St",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727588637",
            "country_code": "US",
            "telephone_number": "479-254-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ARKANSAS CHILDREN'S MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-364-2090",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 7, 2022; 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.

Verify at the official NPI Registry.