Individual provider Active NPI

Andrew G Kumpuris, MD

  • Cardiovascular Disease Physician
  • Little Rock, AR
National Provider Identifier
1669483293
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
R-2258 Issued in AR
Practice address
415 N University Ave
Little Rock, AR 72205-3108
Phone
(501) 664-6841
Fax
(501) 664-0296
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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 R-2258 AR Primary

Addresses

Primary practice location

415 N University Ave
Little Rock, AR 72205-3108

Mailing address

415 N University Ave
Little Rock, AR 72205-3108
Phone (501) 664-6841

Other identifiers 2

IdentifierTypeStateIssuer
104807001MedicaidAR
89-X674OtherARMALP INS

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
I20040707001404 AR Practitioner - Cardiovascular Disease (Cardiology) 1254319270 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Cardiovascular Disease CurrentSince Aug 23, 2011 Accepting new patients
St. Vincent Infirmary Medical Center Current Accepting new patients
Arkansas Health Group CurrentSince Mar 15, 1996 Accepting new patients
Arkansas Health Group CurrentSince Mar 15, 1996 Accepting new patients
Heart Clinic Arkansas Cardiovascular Disease Current Accepting new patients
Baptist Health CurrentSince Aug 23, 2011 Accepting new patients
Arkansas Cardiology Cardiovascular Disease Past Accepting new patients
St Vincent Physician Clinics LLC Past Accepting new patients

Locations

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

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

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

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

415 N University Ave
Little Rock, AR 72205
Phone (501) 664-6841

9601 Interstate 630
#7
Little Rock, AR 72205
Phone (501) 202-3995

1708 N Buerkle St
Stuttgart, AR 72160
Phone (870) 659-8050

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1669483293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N UNIVERSITY AVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053108",
            "telephone_number": "501-664-6841",
            "fax_number": "501-664-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N UNIVERSITY AVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053108",
            "telephone_number": "501-664-6841",
            "fax_number": "501-664-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMPURIS",
        "first_name": "ANDREW",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AR",
            "license": "R-2258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104807001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MALP INS",
            "identifier": "89-X674",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.