NPIMap

Organization Active NPI

Arkansas Surgical Hospital, LLC

  • Family Medicine Physician
  • North Little Rock, AR
National Provider Identifier
1407466626
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ARKANSAS SURGICAL HOSPITAL, LLC
Practice address
5201 Northshore Dr
North Little Rock, AR 72118-5312
Phone
(501) 748-8000
NPI assigned
Aug 3, 2020
Last updated
Aug 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Authorized official

Name
Christopher Brian Fowler
Title
Ceo
Phone
(501) 748-8089

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5201 Northshore Dr
North Little Rock, AR 72118-5312

Mailing address

5201 Northshore Dr
North Little Rock, AR 72118-5312
Phone (501) 748-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181017000632 AR Part B Supplier - Clinic/Group Practice 5496793390 Receives reassigned benefits from 77 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Conway, AR; North Little Rock, AR

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ar SRGL Hosp LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 45

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 45

NPI Registry JSON

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596412800000",
    "number": "1407466626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 NORTHSHORE DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721185312",
            "telephone_number": "501-748-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 NORTHSHORE DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721185312",
            "telephone_number": "501-748-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS SURGICAL HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "501-748-8089"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.