Individual provider Active NPI

Russell Paul Tarr, MD

  • Emergency Medicine Physician
  • Little Rock, AR
National Provider Identifier
1831203157
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E-4882 Issued in AR
Practice address
16221 St Vincent Way
Suite 100
Little Rock, AR 72223
Phone
(501) 552-8150
Fax
(501) 552-8199
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E-4882 AR Primary

Addresses

Primary practice location

16221 St Vincent Way
Suite 100
Little Rock, AR 72223

Mailing address

16221 St Vincent Way
Suite 100
Little Rock, AR 72223
Phone (501) 552-8150

Other practice location 1

4601 Woodlawn Dr
Little Rock, AR 72205-3860
Phone (501) 664-0769

Other identifiers 1

IdentifierTypeStateIssuer
E4882OtherARALLOPATHIC PHYSICIAN LIC

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
I20070209000156 AR Practitioner - Emergency Medicine 8527060235 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Oct 28, 2024 Accepting new patients
Petite Roche Emergency Physicians Emergency Medicine Past Accepting new patients
Arkansas Gatewood Emergency Room Services, PA Emergency Medicine Past Accepting new patients
Petit Jean Emergency Physicians Emergency Medicine Past Accepting new patients
Caddoes Emergency Physicians LLC Emergency Medicine PastSince Oct 8, 2007 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1831203157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16221 ST VINCENT WAY",
            "address_2": "SUITE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72223",
            "telephone_number": "501-552-8150",
            "fax_number": "501-552-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16221 ST VINCENT WAY",
            "address_2": "SUITE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72223",
            "telephone_number": "501-552-8150",
            "fax_number": "501-552-8199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4601 Woodlawn Dr",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722053860",
            "country_code": "US",
            "telephone_number": "501-664-0769",
            "fax_number": "501-960-8987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TARR",
        "first_name": "RUSSELL",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-4882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLOPATHIC PHYSICIAN LIC",
            "identifier": "E4882",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.