NPIMap

Individual provider Active NPI

Michael S Higginbotham, MD

  • Family Medicine Physician
  • Rockport, AR
National Provider Identifier
1619992377
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E0968 Issued in AR
Practice address
1580 Tanner St
Rockport, AR 72104-2023
Phone
(501) 332-7981
Fax
(501) 337-9964
NPI assigned
Jul 13, 2006
Last updated
Sep 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E0968 AR Primary

Addresses

Primary practice location

1580 Tanner St
Rockport, AR 72104-2023

Mailing address

1580 Tanner St
Rockport, AR 72104-2023
Phone (501) 332-7981

Other identifiers 1

IdentifierTypeStateIssuer
129994001MedicaidAR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michael.higginbotham@hfcclinic.eclinicaldirectplus.com

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
I20040813000378 AR Practitioner - Family PracticePractitioner - Emergency MedicinePractitioner - Allergy/Immunology 5991778482 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Allergy/Immunology
Education
University of Arkansas College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Covenant Health LLCGroup PAC ID 9133519531, 7 clinicians

Practice addresses (Care Compare)

1580 Tanner St
Rockport, AR 72104-2023
Phone (501) 337-9994

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision20
Removal of skin lesions43
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E0968ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shane Higginbotham MD PA Family Medicine Current Accepting new patients
Covenant Health LLC CurrentSince Nov 11, 2021 Accepting new patients

Locations

1002 Schneider Dr
Ste 103
Malvern, AR 72104
Phone (501) 332-1012

1002 Schneider Dr
Ste 104
Malvern, AR 72104
Phone (501) 332-7981

1580 Tanner St
Rockport, AR 72104
Phone (501) 337-9994

Interoperability endpoints

  • Direct secure messaging: michael.higginbotham@hfcclinic.eclinicaldirectplus.com
  • Direct secure messaging: michael.higginbotham@hfclinic.eclinicaldirectplus.com

Organizations & group practices 3

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1619992377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 TANNER ST",
            "city": "ROCKPORT",
            "state": "AR",
            "postal_code": "721042023",
            "telephone_number": "501-332-7981",
            "fax_number": "501-337-9964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 TANNER ST",
            "city": "ROCKPORT",
            "state": "AR",
            "postal_code": "721042023",
            "telephone_number": "501-332-7981",
            "fax_number": "501-337-9964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINBOTHAM",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E0968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129994001",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.higginbotham@hfcclinic.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1002 Schneider Dr Ste 104",
            "city": "Malvern",
            "state": "AR",
            "country_code": "US",
            "postal_code": "721044823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockport, AR

Sources for this page

Verify at the official NPI Registry.