Individual provider Active NPI

Gohar Azhar, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Little Rock, AR
National Provider Identifier
1508804899
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
E-3515 Issued in AR
Practice address
4301 W Markham St
Reynolds Center on Aging #748
Little Rock, AR 72205-7101
Phone
(501) 526-5821
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 152814 MA
Geriatric Medicine (Internal Medicine) Physician 207RG0300X E-3515 AR Primary

Addresses

Primary practice location

4301 W Markham St
Reynolds Center on Aging #748
Little Rock, AR 72205-7101

Mailing address

4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other identifiers 5

IdentifierTypeStateIssuer
149039001MedicaidAR
5M440OtherARBCBS
E3515OtherARTRICARE
380001926OtherARRAILROAD MEDICARE
03020016700OtherARQUALCHOICE

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
I20090820000815 AR Practitioner - Geriatric Medicine 8325192610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4301 W Markam St
Little Rock, AR 72205-7101
Phone (501) 686-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
152814MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Internal Medicine CurrentSince Jul 10, 2009 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 10, 2009 Accepting new patients

Locations

521 Jack Stephens Dr
Little Rock, AR 72205
Phone (501) 296-1200

4301 W Markham St
#748
Little Rock, AR 72205
Phone (501) 686-6219

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

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

Organizations & group practices 2

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251936000000",
    "number": "1508804899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST",
            "address_2": "REYNOLDS CENTER ON AGING #748",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-526-5821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZHAR",
        "first_name": "GOHAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2009-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "152814",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AR",
            "license": "E-3515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149039001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5M440",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "E3515",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "380001926",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "03020016700",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.