NPIMap

Individual provider Active NPI

Rachelle Ariele Gietzen, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Little Rock, AR
National Provider Identifier
1588219455
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
E-16150 Issued in AR
Practice address
10810 Executive Center Dr Ste 100
Little Rock, AR 72211-4386
Phone
(501) 604-2695
NPI assigned
Aug 7, 2019
Last updated
Feb 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X BP10067750 TX
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X E-16150 AR Primary

Addresses

Primary practice location

10810 Executive Center Dr Ste 100
Little Rock, AR 72211-4386

Mailing address

10810 Executive Center Dr Ste 100
Little Rock, AR 72211-4386
Phone (501) 604-2695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240305003990 AR Practitioner - Pathology 8921443516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephropathology Associates, PLCGroup PAC ID 6901707405, 30 clinicians

Practice addresses (Care Compare)

10810 Executive Ctr Dr
Suite 100
Little Rock, AR 72211-4386
Phone (501) 604-2695

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10067750TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephropathology Associates, PLC CurrentSince Feb 22, 2024 Accepting new patients
Nephropathology Associates, PLC Past Accepting new patients

Locations

10810 Executive Center Dr
Ste 100
Little Rock, AR 72211
Phone (501) 604-2695

Organizations & group practices 2

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.

Hospital & facility affiliations 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1588219455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10810 EXECUTIVE CENTER DR STE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114386",
            "telephone_number": "501-604-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10810 EXECUTIVE CENTER DR STE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114386",
            "telephone_number": "501-604-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIETZEN",
        "first_name": "RACHELLE",
        "middle_name": "ARIELE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "BP10067750",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AR",
            "license": "E-16150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.