Individual provider Active NPI

Rachel Dyan Golden, PA

  • Physician Assistant
  • Little Rock, AR
National Provider Identifier
1457690414
Registry record updated Feb 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-496 Issued in AR
Practice address
9200 Cloverhill Rd
Little Rock, AR 72205-4615
Phone
(501) 276-2804
NPI assigned
Feb 11, 2013
Last updated
Feb 11, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-496 AR Primary

Addresses

Primary practice location

9200 Cloverhill Rd
Little Rock, AR 72205-4615

Mailing address

9200 Cloverhill Rd
Little Rock, AR 72205-4615
Phone (501) 276-2804

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130422000021 AR Practitioner - Physician Assistant 7517103427 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Infirmary Medical Center CurrentSince Feb 17, 2017 Accepting new patients
St Vincent Physician Clinics LLC Past Accepting new patients

Locations

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

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

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1360540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360540800000",
    "number": "1457690414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 CLOVERHILL RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054615",
            "telephone_number": "501-276-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 CLOVERHILL RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054615",
            "telephone_number": "501-276-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDEN",
        "first_name": "RACHEL",
        "middle_name": "DYAN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-11",
        "last_updated": "2013-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.