Charles D Carttar, M.D.
Individual provider Active NPI Adult Medicine Physician · Little Rock, AR
NPI 1750367199 · NPPES record last updated Dec 28, 2016
Key facts
- NPI
- 1750367199
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Medicine Physician 207QA0505X
- License
- C5828 (AR)
- Practice address
- 4601 Woodlawn Dr
Little Rock, AR 72205-3860 - Phone
- (501) 664-0769
- Fax
- (501) 664-9558
- NPI assigned
- Dec 19, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060112000147 | AR | Practitioner - Internal Medicine |
6608784889 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C5828 | AR | MD | Adult Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Horizon Orthorehab Clinic, LTD | Current |
Accepting new patients | |
| HCC of Magnolia LLC | Current |
Accepting new patients | |
| St Vincent Physician Clinics LLC | Past | Accepting new patients | |
| Health Management of Arkansas | Past |
Accepting new patients | |
| Benny J Green MD PA | Past |
Accepting new patients |
Locations
101 Hospital Dr
Magnolia, AR 71753
Phone (870) 235-3000
4100 Landers Rd
North Little Rock, AR 72117
Phone (501) 916-2299
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | C5828 | AR | Yes |
Addresses
Primary practice location
4601 Woodlawn Dr
Little Rock, AR 72205-3860
Mailing address
4601 Woodlawn Dr
Little Rock, AR 72205-3860
Phone (501) 664-0769
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111257001 | Medicaid | AR |
Other providers in Little Rock, AR
- Victor Carter
- Zenobia Carter
- Carter'S Crew
- Carti Cancer Center
- Carti Oncology Solutions LLC
- Angela Cartwright
- Angela Eileen Cartwright
- Terrance Cartwright
- Caruthers & Wolverton PLLC
- Caruthers and Wolverton, PLLC
All providers in Little Rock, AR · Adult Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.