Individual provider Active NPI

Charles A Musgrove, M.D.

  • Emergency Medicine Physician
  • Little Rock, AR
National Provider Identifier
1700106457
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E-7268 Issued in AR
Practice address
4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone
(501) 686-8000
NPI assigned
Jun 4, 2010
Last updated
Nov 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X E-7268 AR Primary

Addresses

Primary practice location

4301 W Markham St # 783
Little Rock, AR 72205-7101

Mailing address

1807 Osceola Dr
North Little Rock, AR 72116-4520
Phone (479) 234-5256

Other identifiers 1

IdentifierTypeStateIssuer
190460001MedicaidAR

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
I20120126000347 AR Practitioner - Emergency Medicine 3274700679 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-7268ARMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Arkansas Emergency Physicians, LLP Emergency Medicine CurrentSince Mar 1, 2015 Accepting new patients
Arkansas Emergency Staffing Solutions, Inc Emergency Medicine CurrentSince Jan 20, 2012 Accepting new patients
Washington Regional Medical System CurrentSince Aug 1, 2013 Accepting new patients
Washington Regional Medical System CurrentSince Aug 1, 2013 Accepting new patients
South Arkansas Emergency Physicians, LLP Emergency Medicine CurrentSince Mar 1, 2015 Accepting new patients
South Arkansas Emergency Physicians LLP Emergency Medicine Current Accepting new patients
Washington Regional Medical Center Past Accepting new patients

Locations

3000 Medical Center Pkwy
Bentonville, AR 72712
Phone (479) 553-2524

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1025

609 W Maple Ave
Springdale, AR 72764
Phone (479) 751-5711

Interoperability endpoints

  • Direct secure messaging: cmusgrove36238@washingtonregional.direct-ci.com

Organizations & group practices 7

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": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1700106457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 OSCEOLA DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721164520",
            "telephone_number": "479-234-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSGROVE",
        "first_name": "CHARLES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-04",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-7268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190460001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.