NPIMap

Individual provider Active NPI

Edwin Duane Sherwood, MD

  • Emergency Medicine Physician
  • Little Rock, AR
National Provider Identifier
1720192024
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
C-8306 Issued in AR
Practice address
2 Saint Vincent's Circle
Little Rock, AR 72205
Phone
(501) 552-2678
NPI assigned
Aug 17, 2006
Last updated
Nov 17, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C-8306 AR Primary

Addresses

Primary practice location

2 Saint Vincent's Circle
Little Rock, AR 72205

Mailing address

PO Box 684
Searcy, AR 72145-0684
Phone (501) 230-2170

Other identifiers 2

IdentifierTypeStateIssuer
123627001MedicaidAR
930086912OtherARRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060328000027 AR Practitioner - Emergency Medicine 1557379989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Arkansas College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
White River Health System, Inc.Group PAC ID 0143134270, 190 clinicians

Practice addresses (Care Compare)

1710 Harrison St Slot
24 White River Emergency Physicians
Batesville, AR 72501-7303
Phone (870) 262-1240

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C-8306ARMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
White River Health System, Inc Emergency Medicine CurrentSince Nov 20, 2016 Accepting new patients
White River Health System, Inc. CurrentSince Nov 20, 2016 Accepting new patients
Dr B. E. Holmes PA Past Accepting new patients
Northeast Arkansas Clinic, PA Past Accepting new patients
Sherwood Urgent Care Past Accepting new patients
Petite Roche Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

1710 Harrison St
Batesville, AR 72501
Phone (870) 262-1240

1710 Harrison St
#24
Batesville, AR 72501
Phone (870) 262-1240

Organizations & group practices 7

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.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1720192024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 684",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721450684",
            "telephone_number": "501-230-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SAINT VINCENT'S CIRCLE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72205",
            "telephone_number": "501-552-2678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERWOOD",
        "first_name": "EDWIN",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "C-8306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123627001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930086912",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.