Individual provider Active NPI

Kathryn Speights, PA-C

  • Medical Physician Assistant
  • Little Rock, AR
National Provider Identifier
1801211966
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA-556 Issued in AR
Practice address
4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone
(501) 686-8000
Fax
(501) 526-6562
NPI assigned
Feb 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X P-T1406 AR
Medical Physician Assistant 363AM0700X PA-556 AR Primary

Addresses

Primary practice location

4301 W Markham St # 783
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

1014 Harkrider St
Ste B
Conway, AR 72032-4404
Phone (501) 327-7100

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161004001167 AR Practitioner - Physician Assistant 3375831506 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4301 W Markam St
Little Rock, AR 72205-7101

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
P-T1406ARMDPhysician Assistant
PA-556ARMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Jun 3, 2021 Accepting new patients
J.P. Wornock M.D. P.a. CurrentSince Jan 4, 2016 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jun 3, 2021 Accepting new patients

Locations

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

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

400 S Main St
Ste 100
Searcy, AR 72143
Phone (501) 279-9000

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.

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": "1393372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1801211966",
    "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": "501-526-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "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": "501-526-6562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1014 Harkrider St",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "AR",
            "postal_code": "720324404",
            "country_code": "US",
            "telephone_number": "501-327-7100",
            "fax_number": "501-327-7121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPEIGHTS",
        "first_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-26",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "P-T1406",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AR",
            "license": "PA-556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.