Individual provider Active NPI

William D Dedman, MD

  • Family Medicine Physician
  • Camden, AR
National Provider Identifier
1750342804
Registry record updated Oct 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C5835 Issued in AR
Practice address
353 Cash Rd SW
Camden, AR 71701-3704
Phone
(870) 836-8101
NPI assigned
Mar 29, 2006
Last updated
Oct 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C5835 AR Primary

Addresses

Primary practice location

353 Cash Rd SW
Camden, AR 71701-3704

Mailing address

PO Box 757
Camden, AR 71711-0757

Other identifiers 6

IdentifierTypeStateIssuer
13273000000OtherARQUALCHOICE
0122136OtherARUNITED HEALTHCARE
770001401OtherARBREASTCARE
4389541OtherAETNA
103666001MedicaidAR
271402OtherARHEALTHLINK

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
I20100520000693 AR Practitioner - Family Practice 6002945672 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C5835ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group Family Medicine CurrentSince Mar 1, 1996 Accepting new patients
Arkansas Health Group CurrentSince Mar 1, 1996 Accepting new patients
Baptist Health Past Accepting new patients

Locations

353 Cash Rd SW
Camden, AR 71701
Phone (870) 836-8101

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

Interoperability endpoints

  • Direct secure messaging: wdedman3421@direct.baptist-healthar.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222992000000",
    "number": "1750342804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 757",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717110757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 CASH RD SW",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717013704",
            "telephone_number": "870-836-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDMAN",
        "first_name": "WILLIAM",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2008-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C5835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "13273000000",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0122136",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BREASTCARE",
            "identifier": "770001401",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4389541",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103666001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "271402",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, AR

Sources for this page

Verify at the official NPI Registry.