Derrick Le'Mon Sloan Jr, MD SLOAN

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

IS456210 Issued in AR

Practice address

900 N 7TH St
West Memphis, AR 72301-2001

Phone

(574) 943-5094

NPI assigned

Mar 10, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1619625522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3119 S PALM ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716035772",
            "telephone_number": "708-846-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N 7TH ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723012001",
            "telephone_number": "574-943-5094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOAN JR",
        "first_name": "DERRICK LE'MON",
        "credential": "MD SLOAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "IS456210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4642271023",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Direct",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "900 N 7th St",
            "city": "West Memphis",
            "state": "AR",
            "country_code": "US",
            "postal_code": "723012001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert T Shull Jr., MD
• Catlyn Nicole Sills, SLP
• Dimonah Sims, PLMSW
• Tiffany T Sims
• Elizabeth Slagley, MHPP
• Ashley Sloan, PTA
• Small Talk
• Tanequa Danielle Small, LMSW
• Tammy Lynn Smart, LMSW
• Brenan Davis Smith, DNP, APRN, FNP-C

• All providers in West Memphis, AR
• Internal Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.