Individual provider Active NPI

Laura Sisterhen, MD

  • Pediatrics Physician
  • Little Rock, AR
National Provider Identifier
1780774349
Registry record updated Mar 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
E-4045 Issued in AR
Practice address
1 Childrens Way Slot# 653
Little Rock, AR 72202-3510
Phone
(501) 364-1100
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X E-4045 AR Primary

Addresses

Primary practice location

1 Childrens Way Slot# 653
Little Rock, AR 72202-3510

Mailing address

1 Childrens Way Slot # 653
Little Rock, AR 72202-3510
Phone (501) 364-1100

Other identifiers 1

IdentifierTypeStateIssuer
154209001MedicaidAR

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
I20040615001886 AR Practitioner - Pediatric Medicine 7618951849 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-4045ARMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Childrens Professional Services Organization LLC Pediatrics CurrentSince Jul 1, 2025 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jan 3, 2010 Accepting new patients
University of Arkansas for Medical Sciences Pediatrics CurrentSince Jan 3, 2010 Accepting new patients
Arkansas Childrens Hospital Past Accepting new patients
University of Arkansas for Medical Sciences Pediatrics Past Accepting new patients

Locations

800 Marshall St
Ste 653
Little Rock, AR 72202
Phone (501) 364-4020

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
Ste 653
Little Rock, AR 72202

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1780774349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY SLOT # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023510",
            "telephone_number": "501-364-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY SLOT# 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023510",
            "telephone_number": "501-364-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISTERHEN",
        "first_name": "LAURA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-4045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154209001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.