NPIMap

Individual provider Active NPI

Divyaswathi Citla Sridhar, MD

  • Pediatric Hematology & Oncology Physician
  • Little Rock, AR
National Provider Identifier
1679981229
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
E-12928 Issued in AR
Practice address
1 Childrens Way # 512-10
Little Rock, AR 72202-3500
Phone
(501) 364-2270
Fax
(501) 364-2295
NPI assigned
Jul 28, 2014
Last updated
Aug 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X E-12928 AR
Pediatric Hematology & Oncology Physician 2080P0207X E-12928 AR Primary

Addresses

Primary practice location

1 Childrens Way # 512-10
Little Rock, AR 72202-3500

Mailing address

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200803000027 AR Practitioner - Pediatric MedicinePractitioner - Hematology/Oncology 1456776855 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Hematology/Oncology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Childrens Professional Services Organization LLCGroup PAC ID 4688183148, 180 clinicians

Practice addresses (Care Compare)

1 Childrens Way
Little Rock, AR 72202-3500
Phone (501) 364-2526

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-12928ARMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Aug 1, 2020 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Aug 1, 2020 Accepting new patients
University of Arkansas for Medical Sciences Pediatrics Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Aug 1, 2020 Accepting new patients
Arkansas Children's Hospital CurrentSince Jul 29, 2020 Accepting new patients
University of Arkansas for Medical Sciences Pediatrics Current Accepting new patients
Arkansas Childrens Hospital Pediatrics CurrentSince Jul 29, 2020 Accepting new patients
Arkansas Childrens Professional Services Organization LLC Pediatrics CurrentSince Aug 4, 2025 Accepting new patients
Arkansas Childrens Hospital Past Accepting new patients
Arkansas Childrens Hospital Past Accepting new patients

Locations

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#51210
Little Rock, AR 72202
Phone (501) 364-1494

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
Ste 653
Little Rock, AR 72202

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

Organizations & group practices 10

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 1

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": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1679981229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 512-10",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-2270",
            "fax_number": "501-364-2295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CITLA SRIDHAR",
        "first_name": "DIVYASWATHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-12928",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "AR",
            "license": "E-12928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.