Organization Active NPI

Arkansas Health Group

Doing business as Baptist Health Family Clinic- Perryville

  • Family Medicine Physician
  • Perryville, AR
National Provider Identifier
1831289214
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ARKANSAS HEALTH GROUP
Doing business as
Baptist Health Family Clinic- Perryville
Practice address
518 N Fourche Ave
Perryville, AR 72126-9701
Phone
(501) 889-5543
Fax
(501) 889-5546
NPI assigned
Oct 13, 2006
Last updated
Apr 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Authorized official

Name
Will L Rusher
Title
Ceo
Phone
(501) 812-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

518 N Fourche Ave
Perryville, AR 72126-9701

Mailing address

11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (501) 812-7215

Other identifiers 2

IdentifierTypeStateIssuer
5388075OtherARAETNA
128272002MedicaidAR

Other names 1

  • Baptist Health Family Clinic- Perryville Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040324000111 AR Part B Supplier - Clinic/Group Practice 7911802079 Receives reassigned benefits from 2 practitioners
Practice locations: Perryville, AR

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

10915 N Rodney Parham Rd
Ste G
Little Rock, AR 72212
Phone (501) 202-2001

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

3201 Springhill Dr
Ste 100
North Little Rock, AR 72117
Phone (501) 955-4530

313 W Main St
Perryville, AR 72126
Phone (501) 889-5543

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554940800000",
    "number": "1831289214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "501-812-7215",
            "fax_number": "501-812-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 N FOURCHE AVE",
            "city": "PERRYVILLE",
            "state": "AR",
            "postal_code": "721269701",
            "telephone_number": "501-889-5543",
            "fax_number": "501-889-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS HEALTH GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2019-04-11",
        "status": "A",
        "authorized_official_last_name": "RUSHER",
        "authorized_official_first_name": "WILL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "501-812-7500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5388075",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128272002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Health Family Clinic- Perryville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Perryville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.