NPIMap

Organization Active NPI

Arkansas Health Group

Doing business as Baptist Health Family Clinic-West

  • Family Medicine Physician
  • Little Rock, AR
National Provider Identifier
1528323607
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-5669 Issued in AR
Legal business name
ARKANSAS HEALTH GROUP
Doing business as
Baptist Health Family Clinic-West
Practice address
6015 Chenonceau Blvd
Suite 140
Little Rock, AR 72223-4583
Phone
(501) 868-8410
Fax
(501) 868-8488
NPI assigned
Jul 5, 2012
Last updated
Apr 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Authorized official

Name
Mr. Will L Rusher
Title
Ceo
Phone
(501) 812-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-5669 AR Primary

Addresses

Primary practice location

6015 Chenonceau Blvd
Suite 140
Little Rock, AR 72223-4583

Mailing address

11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (501) 812-7215

Other names 1

  • Baptist Health Family Clinic-West Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120803000152 AR Part B Supplier - Clinic/Group Practice 7911802079 Receives reassigned benefits from 4 practitioners
Practice locations: Little Rock, AR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2043766Baptist Health Family Clinic-West6015 Chenonceau Blvd, Ste 140, Little Rock, AR 72223Certificate of waiverJan 9, 2028

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • Baptist Health

    dba Baptist Health Family Clinic - Russellville

    • Rural Health Clinic/Center
    • Russellville, AR
    • NPI 1689467102

    Member Of

    NPD member

Member organizations 12

Organizations listed as members of this organization in the National Provider Directory.

Locations

6015 Chenonceau Blvd
Ste 140
Little Rock, AR 72223
Phone (501) 868-8410

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554940800000",
    "number": "1528323607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "501-812-7215",
            "fax_number": "501-812-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 CHENONCEAU BLVD",
            "address_2": "SUITE 140",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722234583",
            "telephone_number": "501-868-8410",
            "fax_number": "501-868-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS HEALTH GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-05",
        "last_updated": "2019-04-11",
        "status": "A",
        "authorized_official_last_name": "RUSHER",
        "authorized_official_first_name": "WILL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "501-812-7500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-5669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Health Family Clinic-West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.