Active NPI
Patrick N Osam Sr., MD
- Surgery Physician
- Little Rock, AR
National Provider Identifier
1720030596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- C4850
- Practice address
- 9500 Kanis Road
Ste 501
Little Rock, AR 72205 - Phone
- (501) 227-9080
- Fax
- (501) 227-0410
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | C4850 | AR | Primary |
Addresses
Primary practice location
9500 Kanis Road
Ste 501
Little Rock, AR 72205
Mailing address
9500 Kanis Road
Ste 501
Little Rock, AR 72205
Phone (501) 227-9080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104679001 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C4850 | AR | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277251200000",
"number": "1720030596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9500 KANIS ROAD",
"address_2": "STE 501",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "72205",
"telephone_number": "501-227-9080",
"fax_number": "501-227-0410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 KANIS ROAD",
"address_2": "STE 501",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "72205",
"telephone_number": "501-227-9080",
"fax_number": "501-227-0410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSAM",
"first_name": "PATRICK",
"middle_name": "N",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2010-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AR",
"license": "C4850",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104679001",
"state": "AR"
}
],
"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 Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.