Individual provider Active NPI

Charles D Carttar, M.D.

  • Adult Medicine Physician
  • Little Rock, AR
National Provider Identifier
1750367199
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
C5828 Issued in AR
Practice address
4601 Woodlawn Dr
Little Rock, AR 72205-3860
Phone
(501) 664-0769
Fax
(501) 664-9558
NPI assigned
Dec 19, 2005
Last updated
Dec 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X C5828 AR Primary

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 1

IdentifierTypeStateIssuer
111257001MedicaidAR

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
I20060112000147 AR Practitioner - Internal MedicinePractitioner - Family Practice 6608784889 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C5828ARMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Orthorehab Clinic, LTD CurrentSince Apr 1, 2021 Accepting new patients
HCC of Magnolia LLC CurrentSince Jun 17, 2023 Accepting new patients
Benny J Green MD PA PastSince Jun 1, 1999 Accepting new patients
St Vincent Physician Clinics LLC Past Accepting new patients
Health Management of Arkansas PastSince Mar 2, 2014 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

Organizations & group practices 5

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482883200000",
    "number": "1750367199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 WOODLAWN DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053860",
            "telephone_number": "501-664-0769",
            "fax_number": "501-664-9558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 WOODLAWN DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053860",
            "telephone_number": "501-664-0769",
            "fax_number": "501-664-9558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTTAR",
        "first_name": "CHARLES",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2016-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "AR",
            "license": "C5828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111257001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.