Individual provider Active NPI

John Michael Carney, MD

  • Dermatology Physician
  • Little Rock, AR
National Provider Identifier
1699746370
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
N7400 Issued in AR
Practice address
11321 I-30
Ste 201
Little Rock, AR 72209
Phone
(501) 455-4700
Fax
(501) 455-9044
NPI assigned
Jan 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X N7400 AR Primary

Addresses

Primary practice location

11321 I-30
Ste 201
Little Rock, AR 72209

Mailing address

11321 I-30
Ste 201
Little Rock, AR 72209
Phone (501) 455-4700

Other identifiers 1

IdentifierTypeStateIssuer
117834001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, AR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040610000164 MN Practitioner - Dermatology 5991788085 Reassigns benefits to 1 organization
I20070228000695 AR Practitioner - Dermatology 5991788085 Practice locations: Little Rock, AR

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Northwestern University Feinberg Medical School, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11321 Interstate 30 201
Little Rock, AR 72209-7066
Phone (501) 455-4700

Merit-based Incentive Payment System (MIPS)

Final score
77.03 of 100Reported as individual
Quality
55.01
Improvement activities
40
Cost
83.41

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision29
Removal of skin lesions165
Removal of skin cancer83
Removal or shaving of skin growth1-10
Skin biopsy426

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N7400ARMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Dermatology, SC Dermatology CurrentSince Dec 25, 2019 Accepting new patients

Locations

625 E Nicollet Blvd
Ste 203
Burnsville, MN 55337
Phone (952) 435-2525

4725 36th Ave N
Minneapolis, MN 55422
Phone (763) 231-8700

3655 Plymouth Blvd
Ste 110
Plymouth, MN 55446
Phone (612) 486-4200

779 Bielenberg Dr
Ste 108
Woodbury, MN 55125
Phone (763) 231-8700

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1699746370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11321 I-30",
            "address_2": "STE 201",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72209",
            "telephone_number": "501-455-4700",
            "fax_number": "501-455-9044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11321 I-30",
            "address_2": "STE 201",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72209",
            "telephone_number": "501-455-4700",
            "fax_number": "501-455-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNEY",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AR",
            "license": "N7400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117834001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.