Individual provider Active NPI

Wendall Pahls, M.D.

  • Emergency Medicine Physician
  • Little Rock, AR
National Provider Identifier
1689783706
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
C6493 Issued in AR
Practice address
9601 Interstate 630 Exit 7
Little Rock, AR 72205-7202
Phone
(501) 202-4000
NPI assigned
Aug 30, 2006
Last updated
May 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C6493 AR Primary

Addresses

Primary practice location

9601 Interstate 630 Exit 7
Little Rock, AR 72205-7202

Mailing address

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211-4316
Phone (501) 812-7589

Other identifiers 1

IdentifierTypeStateIssuer
105293001MedicaidAR

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
I20100505000374 AR Practitioner - Emergency MedicinePractitioner - Family Practice 6002944477 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C6493ARMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Medcare, Inc Emergency Medicine CurrentSince Dec 1, 2000 Accepting new patients
Arkansas Health Group Past Accepting new patients

Locations

3050 Twin Rivers Dr
Arkadelphia, AR 71923
Phone (501) 202-2300

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

904 Autumn Rd
Ste 400
Little Rock, AR 72211
Phone (501) 202-4000

9601 Interstate 630
Little Rock, AR 72205
Phone (501) 202-2300

1001 Schneider Dr
Malvern, AR 72104
Phone (501) 332-1000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1689783706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR",
            "address_2": "STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114316",
            "telephone_number": "501-812-7589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 INTERSTATE 630 EXIT 7",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057202",
            "telephone_number": "501-202-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAHLS",
        "first_name": "WENDALL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "C6493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105293001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.