NPIMap

Organization Active NPI

Wound Integrity Arkansas PA

  • Internal Medicine Physician
  • Little Rock, AR
National Provider Identifier
1831709997
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WOUND INTEGRITY ARKANSAS PA
Practice address
13501 Chenal Pkwy Ste 101
Little Rock, AR 72211-5262
Phone
(501) 239-9146
Fax
(501) 251-1377
NPI assigned
Aug 4, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Authorized official

Name
Han Pham Hulen, MD
Title
Ceo
Phone
(214) 945-7313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

13501 Chenal Pkwy Ste 101
Little Rock, AR 72211-5262

Mailing address

1 Chisholm Trail Rd Ste 5200
Round Rock, TX 78681-5090
Phone (512) 202-3830

Other names 1

  • Wound Integrity Arkansas, PA Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210308001029 AR Part B Supplier - Clinic/Group Practice 5496161945 Receives reassigned benefits from 11 practitioners
Practice locations: Fort Smith, AR; Little Rock, AR

National Provider Directory

National Provider Directory

Locations

13501 Chenal Pkwy
Ste 101
Little Rock, AR 72211
Phone (501) 239-9146

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701388800000",
    "number": "1831709997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHISHOLM TRAIL RD STE 5200",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786815090",
            "telephone_number": "512-202-3830",
            "fax_number": "512-354-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13501 CHENAL PKWY STE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722115262",
            "telephone_number": "501-239-9146",
            "fax_number": "501-251-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND INTEGRITY ARKANSAS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-04",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A",
        "authorized_official_last_name": "HULEN",
        "authorized_official_first_name": "HAN",
        "authorized_official_middle_name": "PHAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-945-7313",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wound Integrity Arkansas, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 1, 2023; 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.