Organization Active NPI

Disability Treatment Centers of Arkansas

  • Developmental - Behavioral Pediatrics Physician
  • Little Rock, AR
National Provider Identifier
1770822652
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
E-6933 Issued in AR
Legal business name
DISABILITY TREATMENT CENTERS OF ARKANSAS
Practice address
11524 N Rodney Parham Rd
Suite 8B
Little Rock, AR 72212-4187
Phone
(501) 219-8043
Fax
(501) 219-8045
NPI assigned
Feb 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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

Authorized official

Name
Suzy Robertson, CPA
Title
Manager
Phone
(501) 219-8043

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0006X E-6933 AR Primary

Addresses

Primary practice location

11524 N Rodney Parham Rd
Suite 8B
Little Rock, AR 72212-4187

Mailing address

11524 N Rodney Parham Rd
Suite 8B
Little Rock, AR 72212-4187
Phone (501) 219-8043

National Provider Directory

National Provider Directory

Locations

11524 N Rodney Parham Rd
Ste 8B
Little Rock, AR 72212
Phone (501) 219-8043

NPI Registry JSON

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

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1770822652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11524 N RODNEY PARHAM RD",
            "address_2": "SUITE 8B",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722124187",
            "telephone_number": "501-219-8043",
            "fax_number": "501-219-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11524 N RODNEY PARHAM RD",
            "address_2": "SUITE 8B",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722124187",
            "telephone_number": "501-219-8043",
            "fax_number": "501-219-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISABILITY TREATMENT CENTERS OF ARKANSAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-12",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "SUZY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "501-219-8043",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "AR",
            "license": "E-6933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 12, 2013; 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.