Organization Active NPI

River City Dermatology, P.a.

  • Dermatology Physician
  • Little Rock, AR
National Provider Identifier
1629008487
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MC2487 Issued in AR
Legal business name
RIVER CITY DERMATOLOGY, P.A.
Practice address
500 S University Ave
Suite 716
Little Rock, AR 72205-5302
Phone
(501) 228-4664
Fax
(501) 228-0011
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Authorized official

Name
Dr. Jerri Hoskyn, M.D.NPI 1447286711
Title
President
Phone
(501) 228-4664

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
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X MC2487 AR Primary

Addresses

Primary practice location

500 S University Ave
Suite 716
Little Rock, AR 72205-5302

Mailing address

500 S University Ave
Suite 716
Little Rock, AR 72205-5302
Phone (501) 228-4664

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060921000318 AR Part B Supplier - Clinic/Group Practice 8123023306 Receives reassigned benefits from 1 practitioner
Practice locations: Little Rock, AR

National Provider Directory

National Provider Directory

Locations

500 S University Ave
Ste 716
Little Rock, AR 72205
Phone (501) 228-4664

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1629008487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE",
            "address_2": "SUITE 716",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055302",
            "telephone_number": "501-228-4664",
            "fax_number": "501-228-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE",
            "address_2": "SUITE 716",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055302",
            "telephone_number": "501-228-4664",
            "fax_number": "501-228-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER CITY DERMATOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "HOSKYN",
        "authorized_official_first_name": "JERRI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-228-4664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "AR",
            "license": "MC2487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.