Individual provider Active NPI

Freddy Dwight Chrisman, MD

  • Cardiovascular Disease Physician
  • Little Rock, AR
National Provider Identifier
1649241258
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
E2165 Issued in AR
Practice address
9501 Lile Dr
Suite 600
Little Rock, AR 72205-6225
Phone
(501) 227-7596
Fax
(501) 227-7787
NPI assigned
Jan 31, 2006
Last updated
Oct 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X E2165 AR Primary

Addresses

Primary practice location

9501 Lile Dr
Suite 600
Little Rock, AR 72205-6225

Mailing address

9501 Lile Dr
Suite 600
Little Rock, AR 72205-6225
Phone (501) 227-7596

Other identifiers 4

IdentifierTypeStateIssuer
154191001MedicaidAR
CC6745OtherARRAILROAD MEDICARE
CN1884OtherARRAILROAD MEDICARE
5M816OtherARBLUE CROSS BLUE SHIELD

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
I20040515000512 AR Practitioner - Cardiovascular Disease (Cardiology) 9436149978 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Arkansas College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist HealthGroup PAC ID 0648177949, shared by 41 NPIs, 106 clinicians

Practice addresses (Care Compare)

9501 Baptist Health Dr
Suite 600
Little Rock, AR 72205-6231
Phone (501) 227-7596

9601 Baptist Health Dr
Little Rock, AR 72205-6321
Phone (501) 202-3995

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting22
Varicose vein removal50
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Infirmary Medical Center CurrentSince Oct 8, 2009 Accepting new patients
Conway Community Services CurrentSince Sep 18, 2018 Accepting new patients
Baptist Health Cardiovascular Disease Current Accepting new patients
St. Vincent Infirmary Medical Center Current Accepting new patients
Baptist Health Cardiovascular Disease CurrentSince Apr 1, 2012 Accepting new patients
Baptist Health Cardiovascular Disease CurrentSince Jan 1, 2008 Accepting new patients
St Vincent Infirmary Medical Center CurrentSince Oct 8, 2009 Accepting new patients
Conway Community Services CurrentSince Sep 18, 2018 Accepting new patients
Baptist Health CurrentSince Jan 1, 2008 Accepting new patients

Locations

1555 Exchange Ave
Conway, AR 72032
Phone (501) 202-2300

10100 Kanis Rd
Little Rock, AR 72205
Phone (501) 255-6000

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

9501 Baptist Health Dr
Ste 600
Little Rock, AR 72205

9601 Baptist Health Dr
Little Rock, AR 72205
Phone (501) 202-3995

3343 Springhill Dr
Ste 1035
North Little Rock, AR 72117
Phone (501) 975-7676

2215 Wildwood Ave
Sherwood, AR 72120
Phone (501) 522-7100

Interoperability endpoints

  • Direct secure messaging: dchrisman3065@direct.baptist-healthar.org

Organizations & group practices 9

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 6

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1649241258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9501 LILE DR",
            "address_2": "SUITE 600",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056225",
            "telephone_number": "501-227-7596",
            "fax_number": "501-227-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 LILE DR",
            "address_2": "SUITE 600",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056225",
            "telephone_number": "501-227-7596",
            "fax_number": "501-227-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISMAN",
        "first_name": "FREDDY",
        "middle_name": "DWIGHT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AR",
            "license": "E2165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154191001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC6745",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN1884",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5M816",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.