NPIMap

Organization Active NPI

Little Rock Diagnostic Clinic PA

Doing business as Little Rock Diagnostic Clinic ASC

  • Ambulatory Surgical Clinic/Center
  • Little Rock, AR
National Provider Identifier
1760418891
Registry record updated Mar 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
LITTLE ROCK DIAGNOSTIC CLINIC PA
Doing business as
Little Rock Diagnostic Clinic ASC
Practice address
10001 Lile Dr
Little Rock, AR 72205-6217
Phone
(501) 227-8000
Fax
(501) 221-5895
NPI assigned
Jun 23, 2006
Last updated
Mar 7, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2018

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

Authorized official

Name
Darlene Carol Hebda
Title
Credentialing Coordinator
Phone
(501) 223-4543

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X AR Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

10001 Lile Dr
Little Rock, AR 72205-6217

Mailing address

10001 Lile Dr
Little Rock, AR 72205-6217
Phone (501) 227-8000

Other identifiers 1

IdentifierTypeStateIssuer
122223128MedicaidAR

Other names 1

  • Little Rock Diagnostic Clinic ASC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520380800000",
    "number": "1760418891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 LILE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056217",
            "telephone_number": "501-227-8000",
            "fax_number": "501-221-5895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 LILE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056217",
            "telephone_number": "501-227-8000",
            "fax_number": "501-221-5895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE ROCK DIAGNOSTIC CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2018-03-07",
        "status": "A",
        "authorized_official_last_name": "HEBDA",
        "authorized_official_first_name": "DARLENE",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "501-223-4543"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AR",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122223128",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Little Rock Diagnostic Clinic ASC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.