NPIMap

Organization Active NPI

Kenneth E Pearson DDS PA

  • Endodontics
  • Little Rock, AR
National Provider Identifier
1871610857
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
2694 Issued in AR
Legal business name
KENNETH E PEARSON DDS PA
Practice address
12921 Cantrell Rd Suite 200
Little Rock, AR 72223
Phone
(501) 221-1200
Fax
(501) 221-1326
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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

Authorized official

Name
Nancy C Hastings
Title
Office Manager
Phone
(501) 221-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 2694 AR Primary

Addresses

Primary practice location

12921 Cantrell Rd Suite 200
Little Rock, AR 72223

Mailing address

12921 Cantrell Rd Suite 200
Little Rock, AR 72223
Phone (501) 221-1200

Other identifiers 3

IdentifierTypeStateIssuer
56311OtherBCBS
111380608MedicaidAR
696033OtherUNITED CONCORDIA

National Provider Directory

National Provider Directory

Locations

12921 Cantrell Rd
Ste 200
Little Rock, AR 72223
Phone (501) 221-1200

Practitioners & affiliated clinicians

Practitioners 1

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": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1871610857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12921 CANTRELL RD SUITE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72223",
            "telephone_number": "501-221-1200",
            "fax_number": "501-221-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12921 CANTRELL RD SUITE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72223",
            "telephone_number": "501-221-1200",
            "fax_number": "501-221-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH E PEARSON DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "HASTINGS",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "501-221-1200"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "AR",
            "license": "2694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "56311",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111380608",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "696033",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.