Individual provider Active NPI

Avram Zolten, PHD

  • Clinical Neuropsychologist
  • Little Rock, AR
National Provider Identifier
1770572935
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
92-17P Issued in AR
Practice address
8 Shackleford PLZ Ste 201
Little Rock, AR 72211-1853
Phone
(501) 218-8999
Fax
(501) 219-8544
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X
Clinical Psychologist 103TC0700X 92-17P AR
Clinical Neuropsychologist 103G00000X 92-17P AR Primary

Addresses

Primary practice location

8 Shackleford PLZ Ste 201
Little Rock, AR 72211-1853

Mailing address

8 Shackleford PLZ Ste 201
Little Rock, AR 72211-1853
Phone (501) 218-8999

Other identifiers 2

IdentifierTypeStateIssuer
501750000001OtherARQUALCHOICE
122248719MedicaidAR

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110608000214 AR Practitioner - Clinical Psychologist 5193902781 Practice locations: Little Rock, AR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Comprehensive Neuropsychological
8 Shackleford Plaza Suite 201
Little Rock, AR 72211-1826
Phone (501) 219-8999

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
92-17PARMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1770572935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 SHACKLEFORD PLZ STE 201",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722111853",
            "telephone_number": "501-218-8999",
            "fax_number": "501-219-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 SHACKLEFORD PLZ STE 201",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722111853",
            "telephone_number": "501-218-8999",
            "fax_number": "501-219-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLTEN",
        "first_name": "AVRAM",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "92-17P",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AR",
            "license": "92-17P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "501750000001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122248719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.