Serenity Health Center for Women, PA

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

E0253 Issued in AR

Legal business name

SERENITY HEALTH CENTER FOR WOMEN, PA

Practice address

500 S University Ave
Suite 316
Little Rock, AR 72205-5302

Phone

(501) 603-9600

NPI assigned

Mar 15, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christal Waller, RN

Title

Office Administrator

Phone

(501) 603-9600

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871627240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE",
            "address_2": "SUITE 316",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE",
            "address_2": "SUITE 316",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055302",
            "telephone_number": "501-603-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HEALTH CENTER FOR WOMEN, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "CHRISTAL",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "501-603-9600",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AR",
            "license": "E0253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "7420056",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSOURCE",
            "identifier": "04828",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "16047000000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Serenity House, Inc (Serenity Park)
• Serenity Park Operations LLC
• Serenity Park Recovery Clinic
• Serenity Park Treatment Center
• Serenity Supported Living LLC

• Obstetrics & Gynecology Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Obstetrics & Gynecology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.