Individual provider Active NPI

Omololu Longe, MD

  • Family Medicine Physician
  • North Little Rock, AR
National Provider Identifier
1467192039
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-20445 Issued in AR
Practice address
4143 John F Kennedy Blvd
North Little Rock, AR 72116-8264
Phone
(501) 307-7643
Fax
(855) 576-4813
NPI assigned
Mar 31, 2022
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-20445 AR Primary

Addresses

Primary practice location

4143 John F Kennedy Blvd
North Little Rock, AR 72116-8264

Mailing address

102 Woodmont Blvd Ste 600
Nashville, TN 37205-5250
Phone (888) 987-1151

Other practice location 1

1601 W 40th Ave Ste 100
Pine Bluff, AR 71603-6069
Phone (870) 541-6000

Other practice location 2

900 S 3rd St
McGehee, AR 71654
Phone (870) 222-5600

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
I20260505003000 AR Practitioner - Family Practice 8921576216 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Zotec Way
Carmel, IN 46032-0052

10996 Four Seasons PL
Suite 100C
Crown Point, IN 46307-7762

3321 S Bowman Rd
Apt 117
Little Rock, AR 72211-4687

PO Box
Suite 9178
Russellville, AR 72811

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-20445ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Archwell Health Professional Services of Arkansas PA Family Medicine CurrentSince Oct 1, 2026 Accepting new patients
Family Practice Associates of Clarksville,PA PastSince Apr 3, 2022 Accepting new patients

Locations

4143 John F Kennedy Blvd
North Little Rock, AR 72116
Phone (501) 307-7643

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1467192039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250",
            "telephone_number": "888-987-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4143 JOHN F KENNEDY BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721168264",
            "telephone_number": "501-307-7643",
            "fax_number": "855-576-4813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 W 40th Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Pine Bluff",
            "state": "AR",
            "postal_code": "716036069",
            "country_code": "US",
            "telephone_number": "870-541-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 S 3rd St",
            "address_purpose": "LOCATION",
            "city": "McGehee",
            "state": "AR",
            "postal_code": "71654",
            "country_code": "US",
            "telephone_number": "870-222-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONGE",
        "first_name": "OMOLOLU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-31",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-20445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.