Individual provider Active NPI

Jessica Blair Beavers, M.D.

  • Pediatrics Physician
  • Little Rock, AR
National Provider Identifier
1467779140
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
E-7973 Issued in AR
Practice address
1 Childrens Way # 512-19a
Little Rock, AR 72202-3500
Phone
(501) 364-1455
Fax
(501) 364-3418
NPI assigned
Apr 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X E-7973 AR Primary

Addresses

Primary practice location

1 Childrens Way # 512-19a
Little Rock, AR 72202-3500

Mailing address

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

Other practice location 1

4301 W Markham St # 783
Little Rock, AR 72205-7101
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
I20130830000283 AR Practitioner - Pediatric Medicine 4789827213 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-7973ARMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Pediatrics Current Accepting new patients
Arkansas Children'S Hospital CurrentSince Jul 1, 2013 Accepting new patients
Arkansas Childrens Professional Services Organization LLC Pediatrics CurrentSince Jul 1, 2025 Accepting new patients
Arkansas Childrens Hospital Pediatrics CurrentSince Jul 1, 2013 Accepting new patients
University of Arkansas for Medical Sciences Pediatrics Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2013 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2013 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2013 Accepting new patients

Locations

1 Childrens Way
#664
Little Rock, AR 72202
Phone (501) 364-2505

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

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

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

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

1 Childrens Way
#51219A
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
Ste 653
Little Rock, AR 72202

Organizations & group practices 8

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": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1467779140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 512-19A",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1455",
            "fax_number": "501-364-3418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St # 783",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAVERS",
        "first_name": "JESSICA",
        "middle_name": "BLAIR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-21",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-7973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.