NPIMap

Organization Active NPI

St. Vincent-Arkansas Orthopaedic Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Little Rock, AR
National Provider Identifier
1437110293
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
AR3608 Issued in AR
Legal business name
ST. VINCENT-ARKANSAS ORTHOPAEDIC SURGERY CENTER LLC
Practice address
6119 Midtown Ave
1St Floor
Little Rock, AR 72205
Phone
(501) 553-9827
Fax
(501) 553-9836
NPI assigned
Mar 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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

Authorized official

Name
Ken Beasley
Title
Ceo
Phone
(501) 978-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X AR3608 AR Primary

Addresses

Primary practice location

6119 Midtown Ave
1St Floor
Little Rock, AR 72205

Mailing address

6119 Midtown Ave
1St Floor
Little Rock, AR 72205
Phone (501) 553-9827

Other identifiers 2

IdentifierTypeStateIssuer
AR3608OtherARLICENSE NO.
135319128MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090318000446 AR Part B Supplier - Ambulatory Surgical Center 3476610478 Practice locations: Little Rock, AR

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Arkansas Specialty Surgery CenterCCN 04C0001040
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520294400000",
    "number": "1437110293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6119 MIDTOWN AVE",
            "address_2": "1ST FLOOR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72205",
            "telephone_number": "501-553-9827",
            "fax_number": "501-553-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6119 MIDTOWN AVE",
            "address_2": "1ST FLOOR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72205",
            "telephone_number": "501-553-9827",
            "fax_number": "501-553-9836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT-ARKANSAS ORTHOPAEDIC SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "last_updated": "2018-03-06",
        "status": "A",
        "authorized_official_last_name": "BEASLEY",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "501-978-2600"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AR",
            "license": "AR3608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NO.",
            "identifier": "AR3608",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135319128",
            "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 Mar 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.