Active NPI
Intensivist Group,LLC
- Pulmonary Disease Physician
- Conway, AR
National Provider Identifier
1457723884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- Legal business name
- INTENSIVIST GROUP,LLC
- Practice address
- 650 United Dr Ste 200
Conway, AR 72032-7001 - Phone
- (501) 852-5500
- Fax
- (501) 358-6196
- NPI assigned
- Oct 26, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Ladly Abraham
- Title
- President
- Phone
- (501) 852-5500
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | |||
| Pulmonary Disease Physician | 207RP1001X | Primary |
Addresses
Primary practice location
650 United Dr Ste 200
Conway, AR 72032-7001
Mailing address
650 United Dr Ste 200
Conway, AR 72032-7001
Phone (501) 852-5500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Intensivist Group
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pulmonary Disease Physician
- Conway, AR
- NPI 1427413061
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pulmonary Disease Physician
- Conway, AR
- NPI 1972537090
-
- Family Nurse Practitioner
- Conway, AR
- NPI 1679047815
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445817600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1614816000000",
"number": "1457723884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 UNITED DR STE 200",
"city": "CONWAY",
"state": "AR",
"postal_code": "720327001",
"telephone_number": "501-852-5500",
"fax_number": "501-358-6196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 UNITED DR STE 200",
"city": "CONWAY",
"state": "AR",
"postal_code": "720327001",
"telephone_number": "501-852-5500",
"fax_number": "501-358-6196"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTENSIVIST GROUP,LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-10-26",
"last_updated": "2021-03-04",
"certification_date": "2021-03-04",
"status": "A",
"authorized_official_last_name": "ABRAHAM",
"authorized_official_first_name": "LADLY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "501-852-5500",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Critical Care Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Pulmonary Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.