Arkansas Health Group
Organization Active NPI Family Medicine Physician · Cabot, AR
NPI 1689633448 · NPPES record last updated Apr 11, 2019
Key facts
- NPI
- 1689633448
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ARKANSAS HEALTH GROUP
- Practice address
- 205 Westport Dr Ste 1
Cabot, AR 72023-3657 - Phone
- (501) 843-6585
- Fax
- (501) 843-2380
- NPI assigned
- Mar 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Will L Rusher
- Title
- Ceo
- Phone
- (501) 812-7500
Member of 2
Practitioners 12
-
Anne Meredith Brown, PA-C
-
Joseph Brown, APRN
-
Erica Gibson, APRN
-
Michael Jerkins, M.D.
-
Christina M Reid, PA-C
-
Daniel David Ring, PA-C
-
Jennifer L Williams, APRN
-
Tiffany Celeste Wilson, NP-C
-
James A Meserow, M.D., F.A.C.O.G.
-
Edward Jason Vanderburg, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D0466189 | Baptist Health Family Clinic Cabot | Compliance | Dec 13, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060329000704 | AR | Part B Supplier - Clinic/Group Practice | 7911802079 |
Receives reassigned benefits from 12 practitioners Practice locations: Cabot, AR |
National Provider Directory
Locations
11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
205 Westport Dr Ste 1
Cabot, AR 72023-3657
Mailing address
11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (501) 812-7215
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 128283002 | Medicaid | AR |
Other names
- Baptist Health Family Clinic Cabot
Other providers in Cabot, AR
- Arcare
- Arcare
- Arcare
- Kristin Arender
- Arkansas Central Primary Care PLLC
- Arkansas Ip, PLLC
- Arkansas Permanent Cosmetics and Brickhouse Body Art Institute, LLC
- Erin Arnold
- Jennifer Lynn Asbery
- Brenda H Ashley
All providers in Cabot, AR · Family Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.