Individual provider Active NPI

Blake Robert Wiggins, MD

  • Anesthesiology Physician
  • Little Rock, AR
National Provider Identifier
1710564331
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
E-19136 Issued in AR
Practice address
2 Saint Vincent Cir
Little Rock, AR 72205-5423
Phone
(501) 224-1690
NPI assigned
Mar 28, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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
Anesthesiology Physician 207L00000X E-19136 AR Primary

Addresses

Primary practice location

2 Saint Vincent Cir
Little Rock, AR 72205-5423

Mailing address

2 Saint Vincent Cir
Little Rock, AR 72205-5423
Phone (501) 224-1690

Other practice location 1

625 19th St S
Birmingham, AL 35233-1900
Phone (205) 934-6525

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
I20250607000054 AR Practitioner - Anesthesiology 2163822149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Arkansas College of Medicine, 2021
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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-19136ARMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group CurrentSince Jul 1, 2025 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

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

2215 Wildwood Ave
Sherwood, AR 72120
Phone (501) 522-7100

Organizations & group practices 2

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 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": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1710564331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SAINT VINCENT CIR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055423",
            "telephone_number": "501-224-1690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SAINT VINCENT CIR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055423",
            "telephone_number": "501-224-1690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 19th St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331900",
            "country_code": "US",
            "telephone_number": "205-934-6525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "BLAKE",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-28",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E-19136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.