Organization Active NPI

Loretta Depalo, M.D, P.a.

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Little Rock, AR
National Provider Identifier
1659596633
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianTaxonomy code 207PE0005X
Legal business name
LORETTA DEPALO, M.D, P.A.
Practice address
1701 S Shackleford Rd
Little Rock, AR 72211-4335
Phone
(501) 219-7904
Fax
(501) 219-7909
NPI assigned
Apr 16, 2007
Last updated
Oct 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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

Authorized official

Name
Dr. Loretta Depalo, M.D.
Title
Owner
Phone
(501) 219-7904

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X AR Primary

Addresses

Primary practice location

1701 S Shackleford Rd
Little Rock, AR 72211-4335

Mailing address

1701 S Shackleford Rd
Little Rock, AR 72211-4335
Phone (501) 219-7904

Other identifiers 2

IdentifierTypeStateIssuer
E0806OtherARELECTRONIC SUBMITTER
125797001MedicaidAR

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1659596633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 S SHACKLEFORD RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114335",
            "telephone_number": "501-219-7904",
            "fax_number": "501-219-7909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 S SHACKLEFORD RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114335",
            "telephone_number": "501-219-7904",
            "fax_number": "501-219-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORETTA DEPALO, M.D, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "DEPALO",
        "authorized_official_first_name": "LORETTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-219-7904",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELECTRONIC SUBMITTER",
            "identifier": "E0806",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125797001",
            "state": "AR"
        }
    ],
    "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 Oct 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.