NPIMap

Individual provider Active NPI

Jay Daniel Geoghagan, M.D.

  • Cardiovascular Disease Physician
  • North Little Rock, AR
National Provider Identifier
1407840101
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
E-2040 Issued in AR
Practice address
3343 Springhill Dr
Suite 1035
North Little Rock, AR 72117-2929
Phone
(501) 975-7676
Fax
(501) 537-0206
NPI assigned
Sep 8, 2005
Last updated
Oct 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME88853 FL
Cardiovascular Disease Physician 207RC0000X E-2040 AR Primary

Addresses

Primary practice location

3343 Springhill Dr
Suite 1035
North Little Rock, AR 72117-2929

Mailing address

3343 Springhill Dr
Ste 1035
North Little Rock, AR 72117-2929
Phone (501) 975-7676

Other identifiers 3

IdentifierTypeStateIssuer
5N795OtherARBLUE CROSS BLUE SHIELD
CC6745OtherARRAILROAD MEDICARE
CN1884OtherARRAILROAD MEDICARE

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
I20070501000563 AR Practitioner - Cardiovascular Disease (Cardiology) 4082710488 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Arkansas College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist HealthGroup PAC ID 0648177949, shared by 41 NPIs, 106 clinicians

Practice addresses (Care Compare)

3343 Springhill Dr
Suite 1035
North Little Rock, AR 72117-2930
Phone (501) 975-7676

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME88853FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Cardiovascular Disease CurrentSince Apr 1, 2012 Accepting new patients
St. Vincent Infirmary Medical Center CurrentSince Aug 8, 2009 Accepting new patients
Conway Community Services CurrentSince Jan 7, 2019 Accepting new patients
Baptist Health Cardiovascular Disease Current Accepting new patients
St. Vincent Infirmary Medical Center Current Accepting new patients
Baptist Health Cardiovascular Disease CurrentSince Jan 1, 2008 Accepting new patients
St Vincent Infirmary Medical Center CurrentSince Aug 8, 2009 Accepting new patients
Conway Community Services CurrentSince Jan 7, 2019 Accepting new patients
Baptist Health CurrentSince Jan 1, 2008 Accepting new patients

Locations

1555 Exchange Ave
Conway, AR 72032
Phone (501) 202-2300

10100 Kanis Rd
Little Rock, AR 72205
Phone (501) 255-6000

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

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

9501 Baptist Health Dr
Ste 600
Little Rock, AR 72205

9601 Baptist Health Dr
Little Rock, AR 72205
Phone (501) 202-3995

9601 Interstate 630
#7
Little Rock, AR 72205
Phone (501) 202-3995

3343 Springhill Dr
Ste 1035
North Little Rock, AR 72117
Phone (501) 975-7676

Interoperability endpoints

  • Direct secure messaging: jgeoghagan1101@direct.baptist-healthar.org

Organizations & group practices 9

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 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1407840101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3343 SPRINGHILL DR",
            "address_2": "STE 1035",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172929",
            "telephone_number": "501-975-7676",
            "fax_number": "501-537-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3343 SPRINGHILL DR",
            "address_2": "SUITE 1035",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172929",
            "telephone_number": "501-975-7676",
            "fax_number": "501-537-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEOGHAGAN",
        "first_name": "JAY",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME88853",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AR",
            "license": "E-2040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5N795",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC6745",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN1884",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.