NPIMap

Individual provider Active NPI

Khaled M Krisht

  • Neurological Surgery Physician
  • Sherwood, AR
National Provider Identifier
1689822314
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
E-9067 Issued in AR
Practice address
6020 Warden Rd Ste 100
Sherwood, AR 72120-6068
Phone
(501) 552-6400
Fax
(501) 552-6430
NPI assigned
Sep 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 35367 AL
Neurological Surgery Physician 207T00000X E-9067 AR Primary

Addresses

Primary practice location

6020 Warden Rd Ste 100
Sherwood, AR 72120-6068

Mailing address

6020 Warden Rd Ste 100
Sherwood, AR 72120-6068
Phone (501) 552-6400

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
I20150714001862 AR Practitioner - NeurosurgeryPractitioner - Neurology 1759514284 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical GroupGroup PAC ID 5698758803, 237 clinicians

Practice addresses (Care Compare)

2 Saint Vincent Cir
Little Rock, AR 72205-5423
Phone (501) 552-4666

2215 Wildwood Ave
Sherwood, AR 72120-5089
Phone (501) 552-7100

6020 Warden Rd
Suite 100
Sherwood, AR 72120-6015
Phone (501) 552-6400

7709 Hwy 107
Sherwood, AR 72120-4661
Phone (501) 552-7269

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion171
Laminectomy or laminotomy (partial removal of spine bones)44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-9067ARMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group Neurological Surgery CurrentSince Jan 1, 2019 Accepting new patients
Ozarks Medical Center Past Accepting new patients
St Vincent Physician Clinics LLC Past Accepting new patients

Locations

16221 Saint Vincent Way
Little Rock, AR 72223
Phone (501) 221-0888

6020 Warden Rd
Ste 200
Sherwood, AR 72120

6020 Warden Rd
Ste 100
Sherwood, AR 72120
Phone (501) 552-6400

Interoperability endpoints

  • Direct secure messaging: kkrisht457273@direct.stlukeshealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 21

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1220659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1689822314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 WARDEN RD STE 100",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721206068",
            "telephone_number": "501-552-6400",
            "fax_number": "501-552-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 WARDEN RD STE 100",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721206068",
            "telephone_number": "501-552-6400",
            "fax_number": "501-552-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHT",
        "first_name": "KHALED",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-06",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AL",
            "license": "35367",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AR",
            "license": "E-9067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherwood, AR

Sources for this page

Verify at the official NPI Registry.