NPIMap

Individual provider Active NPI

Jeffrey P Kirsch, MD

  • Otolaryngology Physician
  • Conway, AR
National Provider Identifier
1801884622
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
E-2703 Issued in AR
Practice address
2425 Dave Ward Dr
Ste 101
Conway, AR 72034-8686
Phone
(501) 932-7600
Fax
(501) 932-7603
NPI assigned
Oct 6, 2005
Last updated
Sep 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X E2703 AR
Otolaryngology Physician 207Y00000X E-2703 AR Primary

Addresses

Primary practice location

2425 Dave Ward Dr
Ste 101
Conway, AR 72034-8686

Mailing address

2425 Dave Ward Dr
Conway, AR 72034-8679
Phone (501) 932-7600

Other identifiers 1

IdentifierTypeStateIssuer
142402001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081006000670 AR Practitioner - Otolaryngology 6002878121 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Tulane University School of Medicine, 1987
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)

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

9800 Baptist Health Dr
Suite 400
Little Rock, AR 72205-6238
Phone (501) 202-4630

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E2703ARMDSpecialist
E-2703ARMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Aug 1, 2021 Accepting new patients
Arkansas Health Group Otolaryngology CurrentSince Apr 29, 2024 Accepting new patients
University of Arkansas for Medical Sciences Otolaryngology CurrentSince Aug 1, 2021 Accepting new patients
Arkansas Health Group CurrentSince Apr 29, 2024 Accepting new patients
Central Arkansas Ear Nose & Throat Clinic Otolaryngology PastSince Mar 24, 1995 Accepting new patients

Locations

2425 Dave Ward Dr
Ste 101
Conway, AR 72034
Phone (501) 932-7600

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

9500 Kanis Rd
Ste 410
Little Rock, AR 72205
Phone (501) 202-1500

9800 Baptist Health Dr
Ste 400
Little Rock, AR 72205
Phone (501) 202-4630

Interoperability endpoints

  • Direct secure messaging: jkirsch3849@direct.baptist-healthar.org

Organizations & group practices 6

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 9

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1801884622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 DAVE WARD DR",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720348679",
            "telephone_number": "501-932-7600",
            "fax_number": "501-932-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 DAVE WARD DR",
            "address_2": "STE 101",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720348686",
            "telephone_number": "501-932-7600",
            "fax_number": "501-932-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSCH",
        "first_name": "JEFFREY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AR",
            "license": "E2703",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AR",
            "license": "E-2703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142402001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.