Orthoarkansas Spine Institute Procedure Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ORTHOARKANSAS SPINE INSTITUTE PROCEDURE CENTER LLC

Practice address

800 Fair Park Blvd Ste 300
Little Rock, AR 72204-1720

Phone

(501) 813-5621

Fax

(501) 500-4880

NPI assigned

Oct 7, 2020

Organization subpart

No

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

Authorized official

Name

Traci Fox

Title

Administrator

Phone

(501) 900-9797

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Listed as

Orthoarkansas Spine Institute Procedure Center LLCCCN 04C0001105

Medicare certification status

ActiveFrom the Provider of Services file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Orthoarkansas, PA

  • Radiology Clinic/Center
  • Little Rock, AR
  • NPI 1154823961

  Member Of

  NPD member

Locations

Practitioners 2

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

• Rachel Vaske

  • Family Nurse Practitioner
  • Little Rock, AR
  • NPI 1639825508
  NPD
• Eric Houston Gordon, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Little Rock, AR
  • NPI 1295776037
  NPD (past)

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1629675285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FAIR PARK BLVD STE 300",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041720",
            "telephone_number": "501-813-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FAIR PARK BLVD STE 300",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041720",
            "telephone_number": "501-813-5621",
            "fax_number": "501-500-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOARKANSAS SPINE INSTITUTE PROCEDURE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-07",
        "last_updated": "2022-09-14",
        "certification_date": "2021-09-24",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "501-900-9797"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camila Belen Ortega, MD
• Ortho Sport & Spine Physicians Little Rock
• Ortho Sport & Spine Physicians of Arkansas PLLC
• Orthoarkansas Physical, Occupational and Sports Therapy
• Orthoarkansas Special Imaging
• Orthoarkansas, P.a.
• Orthoarkansas, PA
• Orthoarkansas, PA
• Orthoarkansas, PA
• Orthoarkansas, PA

• All providers in Little Rock, AR
• Ambulatory Surgical Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.