Organization Active NPI

Hillcrest Family Practice Clinic Inc

  • Family Medicine Physician
  • Little Rock, AR
National Provider Identifier
1669530606
Registry record updated Aug 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HILLCREST FAMILY PRACTICE CLINIC INC
Practice address
4601 Woodlawn Dr
Little Rock, AR 72205-3860
Phone
(501) 664-0769
Fax
(501) 664-9558
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2009

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

Authorized official

Name
Dr. Jay D Holland, M..
Title
President
Phone
(501) 664-0769

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X AR Primary

Addresses

Primary practice location

4601 Woodlawn Dr
Little Rock, AR 72205-3860

Mailing address

4601 Woodlawn Dr
Little Rock, AR 72205-3860
Phone (501) 664-0769

Other names 1

  • Hillcrest Family Clinic Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D0467316Hillcrest Family Clinic4601 Woodlawn Drive, Little Rock, AR 72205Certificate of waiverMar 24, 2028

National Provider Directory

National Provider Directory

Locations

4601 Woodlawn Dr
Little Rock, AR 72205
Phone (501) 664-0769

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250812800000",
    "number": "1669530606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 WOODLAWN DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053860",
            "telephone_number": "501-664-0769",
            "fax_number": "501-664-9558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 WOODLAWN DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053860",
            "telephone_number": "501-664-0769",
            "fax_number": "501-664-9558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLCREST FAMILY PRACTICE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2009-08-21",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-664-0769",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillcrest Family Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.