Active NPI
Little Rock Diagnostic Clinic PA
- Internal Medicine Physician
- Little Rock, AR
National Provider Identifier
1497784854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- LITTLE ROCK DIAGNOSTIC CLINIC PA
- Practice address
- 10001 Lile Dr
Little Rock, AR 72205-6217 - Phone
- (501) 227-8000
- Fax
- (501) 221-5895
- NPI assigned
- Jun 30, 2006
- 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
- Laura Jackson
- Title
- Quality Manager
- Phone
- (501) 227-8000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
10001 Lile Dr
Little Rock, AR 72205-6217
Mailing address
10001 Lile Dr
Little Rock, AR 72205-6217
Phone (501) 227-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104282002 | Medicaid | AR |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pulmonary Disease Physician
- Little Rock, AR
- NPI 1366470270
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1510099200000",
"number": "1497784854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10001 LILE DR",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722056217",
"telephone_number": "501-227-8000",
"fax_number": "501-221-5895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10001 LILE DR",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722056217",
"telephone_number": "501-227-8000",
"fax_number": "501-221-5895"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LITTLE ROCK DIAGNOSTIC CLINIC PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-30",
"last_updated": "2017-11-08",
"status": "A",
"authorized_official_last_name": "JACKSON",
"authorized_official_first_name": "LAURA",
"authorized_official_title_or_position": "QUALITY MANAGER",
"authorized_official_telephone_number": "501-227-8000"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104282002",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Little Rock, AR
- Little Rock Community Mental Health Center Inc
- Little Rock Community Mental Health Center, Inc.
- Little Rock Counseling, PLC
- Little Rock Dentistry
- Little Rock Dermatology Clinic P.a.
- Little Rock Diagnostic Clinic PA
- Little Rock Dialysis, Inc.
- Little Rock Endocrinology Services
- Little Rock Enrichment Center, Inc.
- Little Rock Eye Clinic, LLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.