Organization Active NPI

Wound Care Consultants of Little Rock, PLLC

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Little Rock, AR
National Provider Identifier
1417216474
Registry record updated May 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianTaxonomy code 207PE0005X
License
C4980 Issued in AR
Legal business name
WOUND CARE CONSULTANTS OF LITTLE ROCK, PLLC
Practice address
106 S Rodney Parham Rd
Little Rock, AR 72205-4708
Phone
(501) 349-8030
Fax
(501) 353-2143
NPI assigned
May 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2012

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

Authorized official

Name
Gary Villines, M.D.
Title
President
Phone
(501) 349-8030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207PE0005X C4980 AR Primary

Addresses

Primary practice location

106 S Rodney Parham Rd
Little Rock, AR 72205-4708

Mailing address

317 Ridgeway Dr
Little Rock, AR 72205-4250
Phone (501) 349-8030

Other identifiers 2

IdentifierTypeStateIssuer
102792001MedicaidAR
C4980OtherARPHYSICIAN LICENSE NUMBER

National Provider Directory

National Provider Directory

Locations

106 S Rodney Parham Rd
Little Rock, AR 72205
Phone (501) 225-2322

NPI Registry JSON

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336694400000",
    "number": "1417216474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 RIDGEWAY DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054250",
            "telephone_number": "501-349-8030",
            "fax_number": "501-353-2143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S RODNEY PARHAM RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054708",
            "telephone_number": "501-349-8030",
            "fax_number": "501-353-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND CARE CONSULTANTS OF LITTLE ROCK, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-11",
        "last_updated": "2012-05-11",
        "status": "A",
        "authorized_official_last_name": "VILLINES",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-349-8030",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "AR",
            "license": "C4980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102792001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE NUMBER",
            "identifier": "C4980",
            "state": "AR"
        }
    ],
    "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 May 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.