NPIMap

Organization Active NPI

Hull Dermatology P.a.

  • Medical Specialty Clinic/Center
  • Rogers, AR
National Provider Identifier
1407082464
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
E3069 Issued in AR
Legal business name
HULL DERMATOLOGY P.A.
Practice address
500 S 52ND St
Rogers, AR 72758-8600
Phone
(479) 254-9662
Fax
(479) 254-9652
NPI assigned
Jun 4, 2009
Last updated
Aug 11, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Authorized official

Name
Dr. Cheryl A Hull, M.D.NPI 1124081849
Title
President
Phone
(479) 254-9662

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X E3069 AR Primary

Addresses

Primary practice location

500 S 52ND St
Rogers, AR 72758-8600

Mailing address

500 S 52ND St
Rogers, AR 72758-8600
Phone (479) 254-9662

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090721000039 AR Part B Supplier - Clinic/Group Practice 1759433881 Receives reassigned benefits from 12 practitioners
Practice locations: Rogers, AR

National Provider Directory

National Provider Directory

Locations

9521 Sunset Dr
Bella Vista, AR 72715

500 S 52nd St
Rogers, AR 72758
Phone (479) 254-9662

597 S Horsebarn Rd
Rogers, AR 72758
Phone (479) 254-9662

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FCIBAA

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281484800000",
    "number": "1407082464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S 52ND ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588600",
            "telephone_number": "479-254-9662",
            "fax_number": "479-254-9652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S 52ND ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588600",
            "telephone_number": "479-254-9662",
            "fax_number": "479-254-9652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HULL DERMATOLOGY P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-04",
        "last_updated": "2010-08-11",
        "status": "A",
        "authorized_official_last_name": "HULL",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-254-9662",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "AR",
            "license": "E3069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.