Individual provider Active NPI

John D Pemberton, D.O.

  • Ophthalmology Physician
  • Little Rock, AR
National Provider Identifier
1528278322
Registry record updated Aug 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
E-6864 Issued in AR
Practice address
4301 W Markham St # 523
Little Rock, AR 72205-7101
Phone
(501) 686-8000
Fax
(501) 526-6780
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X E-6864 AR
Ophthalmology Physician 207W00000X E-6864 AR Primary

Addresses

Primary practice location

4301 W Markham St # 523
Little Rock, AR 72205-7101

Mailing address

4301 W Markham St # 523
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other identifiers 1

IdentifierTypeStateIssuer
186865003MedicaidAR

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
I20110518000660 AR Practitioner - OphthalmologyPractitioner - Other (Physician) 0547346892 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Arkansas for Medical SciencesGroup PAC ID 4082528955, shared by 29 NPIs, 1,159 clinicians

Practice addresses (Care Compare)

1 Childrens Way
Suite 653
Little Rock, AR 72202-3571
Phone (501) 364-1100

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

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
E-6864ARMDOphthalmic Plastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Ophthalmology Current Accepting new patients
Arkansas Children'S Hospital CurrentSince Apr 28, 2011 Accepting new patients
University of Arkansas for Medical Sciences Ophthalmology CurrentSince Apr 28, 2011 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Apr 28, 2011 Accepting new patients
Arkansas Childrens Professional Services Organization LLC CurrentSince Jul 8, 2025 Accepting new patients
Arkansas Childrens Hospital CurrentSince Apr 28, 2011 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Apr 28, 2011 Accepting new patients
South Suburban Ear, Nose & Throat Assoc Inc Past Accepting new patients
Massachusetts Eye and Ear Associates, Inc. Ophthalmology Past Accepting new patients

Locations

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

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

4301 W Markham St
#523
Little Rock, AR 72205
Phone (501) 686-5150

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
Ste 653
Little Rock, AR 72202

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

Organizations & group practices 9

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.

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503273600000",
    "number": "1528278322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 523",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 523",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEMBERTON",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2017-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "AR",
            "license": "E-6864",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AR",
            "license": "E-6864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186865003",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.