NPIMap

Organization Active NPI

Psycamore, LLC

  • Clinic/Center
  • Little Rock, AR
National Provider Identifier
1588024574
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PSYCAMORE, LLC
Practice address
6323 Ranch Dr
Little Rock, AR 72223-4623
Phone
(601) 939-5993
NPI assigned
Mar 3, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Authorized official

Name
Sudhakar Madakasira
Title
Ceo/Medical Director
Phone
(601) 939-5993

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X AR Primary

Addresses

Primary practice location

6323 Ranch Dr
Little Rock, AR 72223-4623

Mailing address

2540 Flowood Dr
Flowood, MS 39232-9362
Phone (601) 939-5993

National Provider Directory

National Provider Directory
Tax ID family
Psycamore LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6323 Ranch Dr
Little Rock, AR 72223
Phone (601) 939-5993

NPI Registry JSON

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1588024574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 FLOWOOD DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329362",
            "telephone_number": "601-939-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6323 RANCH DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722234623",
            "telephone_number": "601-939-5993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCAMORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "MADAKASIRA",
        "authorized_official_first_name": "SUDHAKAR",
        "authorized_official_title_or_position": "CEO/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "601-939-5993"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.