Active NPI
John R Tisdale, M.D.
- Internal Medicine Physician
- Little Rock, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- E-18802
- Practice address
- 1811 Rahling Rd Ste 120
Little Rock, AR 72223-4678 - Phone
- (501) 214-2360
- Fax
- (501) 214-2356
- NPI assigned
- Apr 23, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | E-18802 | AR | |
| Pediatrics Physician | 208000000X | 35.121001 | OH | |
| Internal Medicine Physician | 207R00000X | E-18802 | AR | Primary |
| Internal Medicine Physician | 207R00000X | 35.121001 | OH |
Addresses
Primary practice location
1811 Rahling Rd Ste 120
Little Rock, AR 72223-4678
Mailing address
4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone (501) 686-8000
Other practice location 1
Highway 191 and Hospital Road
Chinle, AZ 86503
Phone (928) 674-7166
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1811 Rahling Rd
Suite 120
Little Rock, AR 72223-4678
Phone (501) 686-8000
Hospital & facility affiliations
- University of Arkansas Medical Sciences
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.86 of 100
- Quality
- 61.32
- Improvement activities
- 40
- Cost
- 90.46
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-18802 | AR | MD | Pediatrics Physician |
| 35.121001 | OH | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS PHS Naihs Chinle Comprehensive Health Care Facility | Current | Accepting new patients | |
| University of Arkansas for Medical Sciences | Current | Accepting new patients | |
| University of Arkansas for Medical Sciences | Internal Medicine | Current | Accepting new patients |
| DHHS PHS Naihs Chinle Comprehensive Health Care Facility | Current | Accepting new patients | |
| DHHS PHS Naihs Chinle Comprehensive | Current | Accepting new patients | |
| Chinle Nursing Home | Past | Accepting new patients |
Locations
4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278
1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874
4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278
1811 Rahling Rd
Ste 120
Little Rock, AR 72223
Phone (501) 214-2360
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Little Rock, AR
- NPI 1588654016
-
- General Acute Care Hospital
- Chinle, AZ
- NPI 1508800129
TX
-
- Family Medicine Physician
- El Dorado, AR
- NPI 1023795051
-
- Ambulatory Surgical Clinic/Center
- Chinle, AZ
- NPI 1922253129
-
- General Acute Care Hospital
- Pinon, AZ
- NPI 1396761565
-
- Adult Care Home Facility
- Chinle, AZ
- NPI 1770753543
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Little Rock, AR
- NPI 1477549756
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764806400000",
"number": "1649414525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 W MARKHAM ST # 783",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722057101",
"telephone_number": "501-686-8000",
"fax_number": "500-526-5148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1811 RAHLING RD STE 120",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722234678",
"telephone_number": "501-214-2360",
"fax_number": "501-214-2356"
}
],
"practiceLocations": [
{
"address_1": "Highway 191 and Hospital Road",
"address_purpose": "LOCATION",
"city": "Chinle",
"state": "AZ",
"postal_code": "86503",
"country_code": "US",
"telephone_number": "928-674-7166",
"fax_number": "928-674-7705",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TISDALE",
"first_name": "JOHN",
"middle_name": "R",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-23",
"last_updated": "2025-12-04",
"certification_date": "2025-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AR",
"license": "E-18802",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "35.121001",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AR",
"license": "E-18802",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35.121001",
"primary": false
}
],
"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 Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.