Individual provider Active NPI

Justin M Bond

  • Certified Registered Nurse Anesthetist
  • Little Rock, AR
National Provider Identifier
1629467535
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
C003069 Issued in AR
Practice address
9601 Baptist Health Dr # Drive7
Little Rock, AR 72205-6321
Phone
(501) 202-2093
Fax
(501) 202-6316
NPI assigned
Jan 15, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X C003069 AR Primary

Addresses

Primary practice location

9601 Baptist Health Dr # Drive7
Little Rock, AR 72205-6321

Mailing address

11001 Executive Center Dr
Little Rock, AR 72211-4316
Phone (501) 202-2093

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150205001818 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991020398 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

1555 Exchange Ave
Arkansas Health Group Anesthesia
Conway, AR 72032-7824
Phone (501) 202-2093

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
C003069ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Anesthesiology Consultants, P.a. CurrentSince Apr 11, 2022 Accepting new patients

Locations

2302 College Ave
Conway, AR 72034
Phone (501) 329-3831

Organizations & group practices 2

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421366400000",
    "number": "1629467535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114316",
            "telephone_number": "501-202-2093",
            "fax_number": "501-202-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 BAPTIST HEALTH DR # DRIVE7",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056321",
            "telephone_number": "501-202-2093",
            "fax_number": "501-202-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOND",
        "first_name": "JUSTIN",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-15",
        "last_updated": "2015-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C003069",
            "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 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.