Individual provider Active NPI

Smitha Hosahalli Vasanna, MD

  • Pediatric Hematology & Oncology Physician
  • Little Rock, AR
National Provider Identifier
1558857946
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
E-18387 Issued in AR
Practice address
1 Childrens Way FL 1
Little Rock, AR 72202-3500
Phone
(501) 364-1479
Fax
(501) 364-3667
NPI assigned
Jul 9, 2018
Last updated
Sep 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X E-18387 AR
Pediatric Hematology & Oncology Physician 2080P0207X E-18387 AR Primary

Addresses

Primary practice location

1 Childrens Way FL 1
Little Rock, AR 72202-3500

Mailing address

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

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
I20241002000181 AR Practitioner - Pediatric MedicinePractitioner - Hematology/Oncology 8224365358 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-18387ARMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Sep 10, 2024 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Sep 10, 2024 Accepting new patients
University of Arkansas for Medical Sciences Pediatrics Current Accepting new patients
Arkansas Children's Hospital CurrentSince Sep 10, 2024 Accepting new patients
Arkansas Childrens Hospital Pediatrics CurrentSince Sep 10, 2024 Accepting new patients
Arkansas Childrens Hospital Past Accepting new patients
Arkansas Childrens Hospital Past Accepting new patients

Locations

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

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
Fl 1
Little Rock, AR 72202
Phone (501) 236-4945

1 Childrens Way
Ste 653
Little Rock, AR 72202

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

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1531094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1558857946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "504-364-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY FL 1",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1479",
            "fax_number": "501-364-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSAHALLI VASANNA",
        "first_name": "SMITHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-09",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-18387",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "AR",
            "license": "E-18387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.