Individual provider Active NPI

Muhammad Younus Shajaat, MD

  • Internal Medicine Physician
  • Jacksonville, AR
National Provider Identifier
1417995457
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E-3419 Issued in AR
Practice address
1400 Braden St
Jacksonville, AR 72076-3721
Phone
(800) 893-9698
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-3419 AR Primary

Addresses

Primary practice location

1400 Braden St
Jacksonville, AR 72076-3721

Mailing address

2101 Wellington Woods Dr
Little Rock, AR 72211-2077
Phone (800) 893-9698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061018000348 AR Practitioner - Emergency Medicine 7416953252 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-3419ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Hope and Health Clinic Associates LLC Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients
Arkansas Pain Care Clinics, PA Internal Medicine CurrentSince Oct 16, 2017 Accepting new patients
Primary Care 360 CurrentSince Dec 8, 2019 Accepting new patients
Arkansas Pain Care Clinics, PA CurrentSince Oct 16, 2017 Accepting new patients

Locations

300 S Shackleford Rd
Ste B
Little Rock, AR 72211
Phone (501) 918-9192

100 Shadow Oaks Dr
Sherwood, AR 72120
Phone (501) 918-9192

7481 Warden Rd
Sherwood, AR 72120
Phone (501) 588-4164

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417995457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 WELLINGTON WOODS DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722112077",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BRADEN ST",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720763721",
            "telephone_number": "800-893-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAJAAT",
        "first_name": "MUHAMMAD",
        "middle_name": "YOUNUS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-3419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, AR

Sources for this page

Verify at the official NPI Registry.