Individual provider Active NPI

Vladimir A Kostyurenko

  • Certified Registered Nurse Anesthetist
  • Little Rock, AR
National Provider Identifier
1710476155
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
C003256 Issued in AR
Practice address
4301 W Markham St # 531
Little Rock, AR 72205-7101
Phone
(501) 686-8818
Fax
(501) 526-7217
NPI assigned
May 1, 2018
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN11019502 FL
Certified Registered Nurse Anesthetist 367500000X C003256 AR Primary
Certified Registered Nurse Anesthetist 367500000X AP61231826 WA

Addresses

Primary practice location

4301 W Markham St # 531
Little Rock, AR 72205-7101

Mailing address

11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (501) 812-7215

Other practice location 1

801 Cottage Dr
Little Rock, AR 72205-5400
Phone (501) 686-8818

Other practice location 2

1800 Bypass Road
Heber Springs, AR 72543-9135
Phone (501) 202-2093

Other practice location 3

1 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 844-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180823001040 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416206537 Reassigns benefits to 8 organizations
I20220616001662 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416206537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Arkansas for Medical SciencesGroup PAC ID 4082528955, shared by 29 NPIs, 1,159 clinicians
Northstar Anesthesia of Florida LLCGroup PAC ID 8921522376, 43 clinicians
Harris and Theodore Anesthesia Services LLCGroup PAC ID 9234374554, 5 clinicians

Practice addresses (Care Compare)

1 Childrens Way
Suite 653
Little Rock, AR 72202-3571
Phone (501) 364-1100

12900 Cortez Blvd
Suite 103
Brooksville, FL 34613-6897
Phone (352) 596-1145

13501 Chenal Pkwy
Suite 102
Little Rock, AR 72211-5262
Phone (501) 451-7843

4301 W Markam St
Little Rock, AR 72205-7101
Phone (501) 686-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Apr 4, 2024 Accepting new patients
St. Vincent Medical Group CurrentSince Mar 1, 2024 Accepting new patients
Harris and Theodore Anesthesia Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 15, 2024 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Apr 4, 2024 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
Arkansas Anesthesia Associates, PLLC. CurrentSince Oct 1, 2024 Accepting new patients
Northstar Anesthesia of Florida LLC CurrentSince Apr 10, 2025 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
Southern Regional Anesthesiology Consultants PLLC CurrentSince Feb 9, 2024 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince May 15, 2023 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Apr 4, 2024 Accepting new patients
Pad Specialists - Little Rock PLLC PastSince Feb 27, 2023 Accepting new patients

Locations

700 W Grove St
El Dorado, AR 71730
Phone (870) 863-2200

300 Werner St
Hot Springs National Park, AR 71913
Phone (501) 622-1000

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

10301 Kanis Rd
Little Rock, AR 72205
Phone (501) 604-4151

13501 Chenal Pkwy
Ste 102
Little Rock, AR 72211
Phone (501) 451-7843

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

1811 Rahling Rd
Ste 120
Little Rock, AR 72223
Phone (501) 214-2360

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
#531
Little Rock, AR 72205
Phone (501) 686-5259

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

500 S University Ave
Ste 500
Little Rock, AR 72205
Phone (501) 320-1101

801 Cottage Dr
Little Rock, AR 72205
Phone (501) 686-8674

4 Hospital Dr
Morrilton, AR 72110
Phone (501) 977-2300

12900 Cortez Blvd
Ste 103
Brooksville, FL 34613
Phone (352) 596-1145

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1710476155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "501-812-7215",
            "fax_number": "501-812-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 531",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8818",
            "fax_number": "501-526-7217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Cottage Dr",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722055400",
            "country_code": "US",
            "telephone_number": "501-686-8818",
            "fax_number": "501-526-7217",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 BYPASS ROAD",
            "address_purpose": "LOCATION",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725439135",
            "country_code": "US",
            "telephone_number": "501-202-2093",
            "fax_number": "501-202-6316",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Tampa General Cir",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063571",
            "country_code": "US",
            "telephone_number": "813-844-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSTYURENKO",
        "first_name": "VLADIMIR",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-01",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11019502",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C003256",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP61231826",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.