NPIMap

Individual provider Active NPI

Pat D O'Donnell, M.D.

  • Urology Physician
  • Little Rock, AR
National Provider Identifier
1720074826
Registry record updated Mar 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
C-4788 Issued in AR
Practice address
4301 W Markham St # 540
Little Rock, AR 72205-7101
Phone
(501) 686-8000
NPI assigned
Sep 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 036112655 IL
Urology Physician 208800000X C-4788 AR Primary

Addresses

Primary practice location

4301 W Markham St # 540
Little Rock, AR 72205-7101

Mailing address

4301 W Markham St # 540
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other identifiers 2

IdentifierTypeStateIssuer
105046001MedicaidAR
036112655MedicaidIL

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21516OKMDClinical Social Worker
11686TNMDPediatric Dentist
C-4788ARMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences PastSince Jan 1, 1990 Accepting new patients
University of Arkansas for Medical Sciences PastSince Jan 1, 1990 Accepting new patients
University of Arkansas for Medical Sciences PastSince Jan 1, 1990 Accepting new patients
Urologic Specialists of Oklahoma Inc Urology Past Accepting new patients
University of Arkansas School of Medical Sciences PastSince Jan 1, 1990 Accepting new patients
University of Arkansas for Medical Sciences PastSince Jan 1, 1990 Accepting new patients
University of Arkansas for Medical Sciences PastSince Jan 1, 1990 Accepting new patients
University of Arkansas for Medical Sciences PastSince Jan 1, 1990 Accepting new patients
Schmieding Developmental Center PastSince Jan 1, 1990 Accepting new patients
University of Arkansas for Medical Sciences PastSince Jan 1, 1990 Accepting new patients
University of Arkansas for Medical Sciences PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236556800000",
    "number": "1720074826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 540",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 540",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "PAT",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2009-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036112655",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AR",
            "license": "C-4788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105046001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112655",
            "state": "IL"
        }
    ],
    "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 Mar 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.