NPIMap

Organization Active NPI

University of Arkansas for Medical Sciences

  • Psychologist
  • Little Rock, AR
National Provider Identifier
1578643045
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Practice address
4301 W Markham St 783
Little Rock, AR 72205
Phone
(501) 686-8000
Fax
(501) 526-5148
NPI assigned
Oct 17, 2006
Last updated
Nov 30, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Authorized official

Name
Amanda D George
Title
Vice Chancellor-Chief Financial Off
Phone
(501) 686-5670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

4301 W Markham St 783
Little Rock, AR 72205

Mailing address

PO Box 251420
Little Rock, AR 72225-1420
Phone (501) 686-8000

Other identifiers 1

IdentifierTypeStateIssuer
118819744MedicaidAR

Other names 1

  • Psychology Services (PhD) Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031219000706 AR Part B Supplier - Clinic/Group Practice 4082528955 Receives reassigned benefits from 2,092 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Little Rock, AR; Maumelle, AR; North Little Rock, AR; Springdale, AR; Alexander, AR; Bentonville, AR; Cabot, AR; Conway, AR…

Other NPIs on the same Medicare enrollment 22

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 22

National Provider Directory

National Provider Directory
Tax ID family
Raymond Bredfeldt MD111 organizations share this tax ID, including this one
Part of
Raymond Bredfeldt MD

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

201 W Van Asche Loop
Fayetteville, AR 72703
Phone (479) 966-4311

Practitioners & affiliated clinicians

Practitioners 58

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.

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669766400000",
    "number": "1578643045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251420",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722251420",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72205",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES",
        "enumeration_date": "2006-10-17",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE CHANCELLOR-CHIEF FINANCIAL OFF",
        "authorized_official_telephone_number": "501-686-5670"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118819744",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychology Services (PhD)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.