Individual provider Active NPI

Deepa Raghavan, MBBS

  • Critical Care Medicine (Internal Medicine) Physician
  • Little Rock, AR
National Provider Identifier
1447439328
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
E8918 Issued in AR
Practice address
4300 W 7TH St
Little Rock, AR 72205-5446
Phone
(016) 865-5255
Fax
(501) 686-7893
NPI assigned
Oct 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E8918 AR
Pulmonary Disease Physician 207RP1001X E8918 AR
Critical Care Medicine (Internal Medicine) Physician 207RC0200X E8918 AR Primary

Addresses

Primary practice location

4300 W 7TH St
Little Rock, AR 72205-5446

Mailing address

PO Box 251420
Little Rock, AR 72225-1420
Phone (501) 686-8000

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
I20141210000072 AR Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 1850613407 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E8918ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Dec 1, 2014 Accepting new patients
University of Arkansas for Medical Sciences Internal Medicine CurrentSince Dec 1, 2014 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2021 Accepting new patients

Locations

4300 W 7th St
Little Rock, AR 72205
Phone (501) 257-5772

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

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": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1447439328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251420",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722251420",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W 7TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055446",
            "telephone_number": "016-865-5255",
            "fax_number": "501-686-7893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHAVAN",
        "first_name": "DEEPA",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-29",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E8918",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AR",
            "license": "E8918",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "AR",
            "license": "E8918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.