Individual provider Active NPI

Donald Mock, MD

  • Pediatric Gastroenterology Physician
  • Little Rock, AR
National Provider Identifier
1720159502
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
R-4373 Issued in AR
Practice address
800 Marshall St # 653
Little Rock, AR 72202-3510
Phone
(501) 364-1100
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X R-4373 AR Primary

Addresses

Primary practice location

800 Marshall St # 653
Little Rock, AR 72202-3510

Mailing address

800 Marshall St # 653
Little Rock, AR 72202-3510
Phone (501) 364-1100

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
I20170317000772 AR Practitioner - Pediatric Medicine 3678858479 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Children'S Hospital CurrentSince Feb 13, 2017 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Feb 13, 2017 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Feb 13, 2017 Accepting new patients
Arkansas Childrens Hospital CurrentSince Feb 13, 2017 Accepting new patients

Locations

800 Marshall St
#653
Little Rock, AR 72202
Phone (501) 354-1100

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

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

Organizations & group practices 5

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720159502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MARSHALL ST # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023510",
            "telephone_number": "501-364-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MARSHALL ST # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023510",
            "telephone_number": "501-364-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCK",
        "first_name": "DONALD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "AR",
            "license": "R-4373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.