NPIMap

Organization Active NPI

Nephropathology Associates, PLC

  • Anatomic Pathology Physician
  • Little Rock, AR
National Provider Identifier
1821156035
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
MC-2034 Issued in AR
Legal business name
NEPHROPATHOLOGY ASSOCIATES, PLC
Practice address
10810 Executive Center Dr
Suite 100
Little Rock, AR 72211-4386
Phone
(501) 604-2695
Fax
(501) 604-2699
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Authorized official

Name
Christopher Patrick Larsen, MDNPI 1447434840
Title
Executive Director, Owner
Phone
(501) 604-2695

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0101X MC-2034 AR Primary
Clinical Medical Laboratory 291U00000X MC-2034 AR

Addresses

Primary practice location

10810 Executive Center Dr
Suite 100
Little Rock, AR 72211-4386

Mailing address

10810 Executive Center Dr
Suite 100
Little Rock, AR 72211-4386
Phone (501) 604-2695

Other identifiers 12

IdentifierTypeStateIssuer
272534MedicaidOR
L00307MedicaidSC
912012200MedicaidFL
95323287MedicaidCO
368483MedicaidAZ
807547100MedicaidID
3810017266BMedicaidWV
529911940MedicaidAL
N210291OtherFLWELLCARE, FL HEALTHEASE ONLY
1504795MedicaidTN
210587601MedicaidTX
200279440 AMedicaidOK

Other names 2

  • Arkana Laboratories Doing business as
  • NephroPath Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040722000261 AR Part B Supplier - Independent Clinical Laboratory 6901707405 Practice locations: Little Rock, AR

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Arkana Laboratories2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1821156035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10810 EXECUTIVE CENTER DR",
            "address_2": "SUITE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114386",
            "telephone_number": "501-604-2695",
            "fax_number": "501-604-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10810 EXECUTIVE CENTER DR",
            "address_2": "SUITE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114386",
            "telephone_number": "501-604-2695",
            "fax_number": "501-604-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROPATHOLOGY ASSOCIATES, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, OWNER",
        "authorized_official_telephone_number": "501-604-2695",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology",
            "state": "AR",
            "license": "MC-2034",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AR",
            "license": "MC-2034",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272534",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L00307",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "912012200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95323287",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "368483",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807547100",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810017266B",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529911940",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE, FL HEALTHEASE ONLY",
            "identifier": "N210291",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1504795",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210587601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200279440 A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arkana Laboratories",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NephroPath",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.