Individual provider Active NPI

Anil Anandam, M.D

  • Geriatric Medicine (Internal Medicine) Physician
  • Little Rock, AR
National Provider Identifier
1801101431
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
E-15605 Issued in AR
Practice address
4301 W Markham St # 795
Little Rock, AR 72205-7101
Phone
(501) 686-5636
Fax
(501) 320-7788
NPI assigned
Aug 6, 2010
Last updated
Sep 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-15605 AR
Internal Medicine Physician 207R00000X 099803 OH
Internal Medicine Physician 207R00000X 25MA10242500 NJ
Geriatric Medicine (Internal Medicine) Physician 207RG0300X E-15605 AR Primary

Addresses

Primary practice location

4301 W Markham St # 795
Little Rock, AR 72205-7101

Mailing address

4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other practice location 1

500 S Cleveland Ave
Westerville, OH 43081-8971
Phone (614) 890-0882

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
I20220926000435 AR Practitioner - Internal MedicinePractitioner - Geriatric Medicine 7719137363 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

3333 Springhill Dr
North Little Rock, AR 72117-2922
Phone (501) 851-7402

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10242500NJMDInternal Medicine Physician
099803OHMDInternal Medicine Physician
E-15605ARMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Sep 12, 2022 Accepting new patients
University of Arkansas for Medical Sciences Internal Medicine Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Sep 12, 2022 Accepting new patients
Arkansas Health Group Internal Medicine CurrentSince Jul 14, 2023 Accepting new patients
Arkansas Health Group CurrentSince Jul 14, 2023 Accepting new patients

Locations

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

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

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
#795
Little Rock, AR 72205
Phone (501) 526-6422

9601 Interstate 630
#7
Little Rock, AR 72205
Phone (501) 202-3995

3333 Springhill Dr
North Little Rock, AR 72117
Phone (501) 202-3000

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1281052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1801101431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 795",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-5636",
            "fax_number": "501-320-7788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 S Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430818971",
            "country_code": "US",
            "telephone_number": "614-890-0882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANANDAM",
        "first_name": "ANIL",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-06",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-15605",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "099803",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA10242500",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AR",
            "license": "E-15605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.