Individual provider Active NPI

Teresa Maxwell, M.D.

  • Emergency Medicine Physician
  • North Little Rock, AR
National Provider Identifier
1629009451
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
C-8450 Issued in AR
Practice address
1805 Hasbrook CT
North Little Rock, AR 72116-5667
Phone
(501) 349-8441
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C-8450 AR Primary

Addresses

Primary practice location

1805 Hasbrook CT
North Little Rock, AR 72116-5667

Mailing address

1805 Hasbrook Court
North Little Rock, AR 72116
Phone (501) 349-8441

Other identifiers 2

IdentifierTypeStateIssuer
129170001MedicaidAR
5J256OtherARARBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050318000379 AR Practitioner - Emergency Medicine 6406801810 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CHI St Vincent Hospital Hot Springs CurrentSince Apr 1, 2015 Accepting new patients
BHG L, LLC Current Accepting new patients
BHG L, LLC CurrentSince Feb 1, 2020 Accepting new patients
CHI St Vincent Hospital Hot Springs Emergency Medicine CurrentSince Apr 1, 2015 Accepting new patients
BHG L, LLC CurrentSince Feb 1, 2020 Accepting new patients
BHG L, LLC Past Accepting new patients
BHG L, LLC Past Accepting new patients
BHG L, LLC Past Accepting new patients
BHG L, LLC Past Accepting new patients
BHG L, LLC Past Accepting new patients
BHG Li, LLC Past Accepting new patients

Locations

255 E College St
Batesville, AR 72501
Phone (870) 569-9862

1058 Front St
Ste 104
Conway, AR 72032
Phone (501) 504-2092

82 W Sunbridge Dr
Fayetteville, AR 72703
Phone (479) 282-2992

1501 S Waldron Rd
Ste 203
Fort Smith, AR 72903
Phone (479) 769-2880

1 Mercy Ln
Ste 403
Hot Springs National Park, AR 71913
Phone (501) 319-7963

300 Werner St
Hot Springs National Park, AR 71913
Phone (501) 622-1000

5510 Southwest Dr
Ste 8
Jonesboro, AR 72404
Phone (870) 520-6313

2231 Trinity Blvd
Texarkana, AR 71854
Phone (870) 330-3210

5001 Spring Vly
Ste 600E
Dallas, TX 75244

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1629009451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 HASBROOK COURT",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "72116",
            "telephone_number": "501-349-8441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 HASBROOK CT",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721165667",
            "telephone_number": "501-349-8441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "TERESA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "C-8450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129170001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARBCBS",
            "identifier": "5J256",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.