Arkansas Primary Care Clinics PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ARKANSAS PRIMARY CARE CLINICS PA

Practice address

6209 W 12TH St
Little Rock, AR 72204-1505

Phone

(501) 663-5221

Fax

(501) 663-6759

NPI assigned

Apr 12, 2006

Last updated

Feb 25, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Derek Lewis, M.D.NPI 1407810641

Title

President

Phone

(501) 663-5221

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

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.

• Derek Lewis, M.D.

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1407810641
  Medicare reassignment Care Compare group NPD Authorized official
• Rose Marie Shaw-Bullock, M.D.

  • Family Medicine Physician
  • N Little Rock, AR
  • NPI 1790749943
  Medicare reassignment Care Compare group NPD
• Vincent Tyrone Morgan, APRN

  • Adult Health Nurse Practitioner
  • Little Rock, AR
  • NPI 1235770942
  Medicare reassignment NPD
• Frederick Braswell, ANP

  • Family Nurse Practitioner
  • Little Rock, AR
  • NPI 1376711937
  NPD (past)
• Heather Denise McKinzie, APN

  • Family Nurse Practitioner
  • Little Rock, AR
  • NPI 1255806493
  NPD (past)
• Demetrius L Pighee, ANP

  • Primary Care Nurse Practitioner
  • Little Rock, AR
  • NPI 1134562697
  NPD (past)
• Ariel Elizabeth Rohde, PA

  • Physician Assistant
  • North Little Rock, AR
  • NPI 1740768944
  NPD (past)
• Regenia D Carter, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Monroe, LA
  • NPI 1144691320
  NPD (past)

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298592000000",
    "number": "1750345427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6209 W 12TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041505",
            "telephone_number": "501-663-5221",
            "fax_number": "501-663-6759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6209 W 12TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041505",
            "telephone_number": "501-663-5221",
            "fax_number": "501-663-6759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS PRIMARY CARE CLINICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-12",
        "last_updated": "2011-02-25",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-663-5221",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116778002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arkansas Pelvic Health PLLC
• Arkansas Perinatal Services
• Arkansas Periodontal Associates
• Arkansas Physicians Eyecare Group Campen, P.a.
• Arkansas Plastic Surgery, P.a.
• Arkansas Psychiatric Clinic Clinical Research Trials, PA
• Arkansas Psychiatric Clinic, Professional Association
• Arkansas Psychiatry and Behavioral Health
• Arkansas Quality Transit
• Arkansas Recovery and Wellness

• Family Medicine Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.