Baptist Health Family Clinic Protho

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

R2917 Issued in AR

Legal business name

BAPTIST HEALTH FAMILY CLINIC PROTHO

Practice address

5207 E Broadway St
North Little Rock, AR 72117-4029

Phone

(501) 945-2033

Fax

(501) 945-2303

NPI assigned

Jan 29, 2013

Organization subpart

Yes

Parent organization

ARKANSAS HEALTH GROUPAs reported in NPPES

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

Authorized official

Name

Mr. Will Rusher

Title

Ceo

Phone

(501) 812-7512

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Arkansas Health Group

  • Colon & Rectal Surgery Physician
  • Little Rock, AR
  • NPI 1336462332

  O20100504000229

  Same enrollment
• Arkansas Health Group

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1649518333

  O20100504000229

  Same enrollment

Part of

Jeffrey S Mayfield

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Baptist Health

  • Rural Health Clinic/Center
  • Sheridan, AR
  • NPI 1255190989

  Member Of

  NPD member
• Baptist Medcare, Inc

  • Emergency Medicine Physician
  • Little Rock, AR
  • NPI 1699868323

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359417600000",
    "number": "1710225545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR",
            "address_2": "SUITE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114316",
            "telephone_number": "501-812-7512",
            "fax_number": "501-812-7507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5207 E BROADWAY ST",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721174029",
            "telephone_number": "501-945-2033",
            "fax_number": "501-945-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST HEALTH FAMILY CLINIC PROTHO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARKANSAS HEALTH GROUP",
        "enumeration_date": "2013-01-29",
        "last_updated": "2013-01-29",
        "status": "A",
        "authorized_official_last_name": "RUSHER",
        "authorized_official_first_name": "WILL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "501-812-7512",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AR",
            "license": "R2917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1048721002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Bannister, COTA/L
• Baptist Health
• Baptist Health
• Baptist Health
• Baptist Health
• James Robert Barber III, M.D.
• Kevin Anthony Barber, M.D.
• Laurie Barber, MD
• Katherine Malinda Barger, CNS,APRN
• Tony Joe Barger, D.C.

• All providers in North Little Rock, AR
• Primary Care Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.