NPIMap

Organization Active NPI

Little Rock Eye Clinic, LLP

  • Ophthalmology Physician
  • North Little Rock, AR
National Provider Identifier
1588025191
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
LITTLE ROCK EYE CLINIC, LLP
Practice address
4104 Richards Rd
North Little Rock, AR 72117-2652
Phone
(501) 224-5658
Fax
(501) 224-8114
NPI assigned
Mar 9, 2016
Organization subpart
Yes
Parent organization
LITTLE ROCK EYE CLINIC, LLPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Authorized official

Name
Dr. Tracy Baltz, M.D.NPI 1881679033
Title
Physician/Owner
Phone
(501) 224-5658

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

4104 Richards Rd
North Little Rock, AR 72117-2652

Mailing address

201 Executive CT
Suite a
Little Rock, AR 72205-4536
Phone (501) 224-5658

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160811002654 AR DME Supplier - Physician - OphthalmologyDME Supplier - Physician - Optometrist 3476535121 Practice locations: North Little Rock, AR

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Little Rock Eye Clinic LLP4104 Richards Rd, North Little Rock, AR 72117-2652(501) 224-5658 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1997

National Provider Directory

National Provider Directory
Tax ID family
Little Rock Eye Clinic3 organizations share this tax ID, including this one
Part of
Little Rock Eye Clinic

Other organizations with this tax ID 2

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

Locations

4104 Richards Rd
North Little Rock, AR 72117
Phone (501) 224-5658

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1457481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1588025191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 EXECUTIVE CT",
            "address_2": "SUITE A",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054536",
            "telephone_number": "501-224-5658",
            "fax_number": "501-224-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4104 RICHARDS RD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172652",
            "telephone_number": "501-224-5658",
            "fax_number": "501-224-8114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE ROCK EYE CLINIC, LLP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LITTLE ROCK EYE CLINIC, LLP",
        "enumeration_date": "2016-03-09",
        "last_updated": "2019-10-16",
        "status": "A",
        "authorized_official_last_name": "BALTZ",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "501-224-5658",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.