Individual provider Active NPI

Megan Rose Gorham, PA-C

  • Physician Assistant
  • Springdale, AR
National Provider Identifier
1851834972
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1073 Issued in AR
Practice address
2601 Gene George Blvd
Springdale, AR 72762-0845
Phone
(479) 725-6800
Fax
(479) 725-6582
NPI assigned
Nov 21, 2016
Last updated
Mar 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-1073 AR Primary

Addresses

Primary practice location

2601 Gene George Blvd
Springdale, AR 72762-0845

Mailing address

PO Box 251418
Little Rock, AR 72225-1418
Phone (501) 364-1100

Other names 1

  • Megan Lomax Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220912002184 AR Practitioner - Physician Assistant 0345625356 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Jun 1, 2022 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jun 1, 2022 Accepting new patients
Arkansas Children's Hospital CurrentSince Jun 1, 2022 Accepting new patients
Arkansas Childrens Hospital CurrentSince Jun 1, 2022 Accepting new patients
Arkansas Childrens Northwest, Inc. Past Accepting new patients
University of Arkansas for Medical Sciences Past Accepting new patients

Locations

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

Interoperability endpoints

  • FHIR API: https://epicproxy.et1036.epichosted.com/APIProxyPRD/AC/api/FHIR/R4

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1851834972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251418",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722251418",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 GENE GEORGE BLVD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620845",
            "telephone_number": "479-725-6800",
            "fax_number": "479-725-6582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORHAM",
        "first_name": "MEGAN",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-1073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "LOMAX",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springdale, AR

Sources for this page

Verify at the official NPI Registry.