Organization Active NPI

Spine Care of Arkansas P.L.L.C

  • Specialist
  • Little Rock, AR
National Provider Identifier
1508064007
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
E2047 Issued in AR
Legal business name
SPINE CARE OF ARKANSAS P.L.L.C
Practice address
14918 Cantrell Rd
Little Rock, AR 72223-4248
Phone
(501) 975-5005
Fax
(501) 975-5008
NPI assigned
Jul 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Authorized official

Name
Mrs. Christy Clay
Title
Insurace Rep
Phone
(501) 975-5005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X E2047 AR Primary

Addresses

Primary practice location

14918 Cantrell Rd
Little Rock, AR 72223-4248

Mailing address

PO Box 34113
Little Rock, AR 72203-4113
Phone (501) 975-5005

Other identifiers 2

IdentifierTypeStateIssuer
5C982OtherARMCR & BCBS PAYOR #
136646001MedicaidAR

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278028800000",
    "number": "1508064007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34113",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722034113",
            "telephone_number": "501-975-5005",
            "fax_number": "501-975-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14918 CANTRELL RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722234248",
            "telephone_number": "501-975-5005",
            "fax_number": "501-975-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE CARE OF ARKANSAS P.L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2010-07-02",
        "status": "A",
        "authorized_official_last_name": "CLAY",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "INSURACE REP",
        "authorized_official_telephone_number": "501-975-5005",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AR",
            "license": "E2047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR & BCBS PAYOR #",
            "identifier": "5C982",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136646001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.