NPIMap

Organization Active NPI

Arkansas Health Group

Doing business as North Little Rock Family Practice Clinic/A Baptist Health Affiliate

  • Family Medicine Physician
  • North Little Rock, AR
National Provider Identifier
1740299478
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ARKANSAS HEALTH GROUP
Doing business as
North Little Rock Family Practice Clinic/A Baptist Health Affiliate
Practice address
505 W Pershing Blvd Ste C
North Little Rock, AR 72114-2157
Phone
(501) 758-7352
Fax
(501) 771-5014
NPI assigned
Aug 5, 2006
Last updated
Apr 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Authorized official

Name
Will Rusher
Title
Ceo/President
Phone
(501) 812-7800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

505 W Pershing Blvd Ste C
North Little Rock, AR 72114-2157

Mailing address

11001 Executive Center Dr
Suite 200
Little Rock, AR 72211-4316
Phone (501) 812-7800

Other identifiers 1

IdentifierTypeStateIssuer
128271002MedicaidAR

Other names 1

  • North Little Rock Family Practice Clinic/A Baptist Health Affiliate Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040624000461 AR Part B Supplier - Clinic/Group Practice 7911802079 Receives reassigned benefits from 4 practitioners
Practice locations: North Little Rock, AR

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

819 W Carpenter St
Benton, AR 72015
Phone (501) 663-6262

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554940800000",
    "number": "1740299478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR",
            "address_2": "SUITE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114316",
            "telephone_number": "501-812-7800",
            "fax_number": "501-812-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 W PERSHING BLVD STE C",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721142157",
            "telephone_number": "501-758-7352",
            "fax_number": "501-771-5014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS HEALTH GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2019-04-11",
        "status": "A",
        "authorized_official_last_name": "RUSHER",
        "authorized_official_first_name": "WILL",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "501-812-7800"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128271002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Little Rock Family Practice Clinic/A Baptist Health Affiliate",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Little Rock Family Practice Clinic/A Baptist Health Affiliate",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.