NPIMap

Individual provider Active NPI

Wilson Wong, MD

  • Clinical Cardiac Electrophysiology Physician
  • Little Rock, AR
National Provider Identifier
1588658983
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
E3348 Issued in AR
Practice address
7 Shackleford West Blvd
Little Rock, AR 72211-3714
Phone
(501) 664-5860
Fax
(501) 664-0889
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X E3348 AR
Clinical Cardiac Electrophysiology Physician 207RC0001X E3348 AR Primary

Addresses

Primary practice location

7 Shackleford West Blvd
Little Rock, AR 72211-3714

Mailing address

7 Shackleford West Blvd
Little Rock, AR 72211-3714
Phone (501) 664-5860

Other identifiers 1

IdentifierTypeStateIssuer
146458001MedicaidAR

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
I20070717000688 AR Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4789784968 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Heart Hospital LLCGroup PAC ID 6002838653, 85 clinicians
Arkansas Heart Hospital Rural Health Services, LLCGroup PAC ID 6204004815, 52 clinicians

Practice addresses (Care Compare)

7 Shackleford W Blvd
Little Rock, AR 72211-3886
Phone (501) 664-5860

900 S 3Rd St
MC Gehee, AR 71654-2562
Phone (501) 664-5860

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E3348ARMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Heart Hospital, LLC Cardiovascular Disease CurrentSince Aug 1, 2011 Accepting new patients
Arkansas Heart Hospital, LLC CurrentSince Aug 1, 2011 Accepting new patients
Arkansas Heart Hospital Rural Health Services, LLC Cardiovascular Disease CurrentSince Aug 1, 2011 Accepting new patients
Little Rock Cardiology Clinic, PA Cardiovascular Disease Past Accepting new patients

Locations

430 Magnolia Rd
Camden, AR 71701
Phone (870) 836-4709

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

7 Shackleford West Blvd
Little Rock, AR 72211
Phone (501) 614-3671

900 S 3rd St
McGehee, AR 71654
Phone (855) 498-6768

205 E Race Ave
Searcy, AR 72143
Phone (501) 279-9000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1588658983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SHACKLEFORD WEST BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113714",
            "telephone_number": "501-664-5860",
            "fax_number": "501-664-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 SHACKLEFORD WEST BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113714",
            "telephone_number": "501-664-5860",
            "fax_number": "501-664-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "WILSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AR",
            "license": "E3348",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "AR",
            "license": "E3348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146458001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.