Organization Active NPI

West Little Rock Womens Center PA

  • Gynecology Physician
  • Little Rock, AR
National Provider Identifier
1871885079
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
WEST LITTLE ROCK WOMENS CENTER PA
Practice address
12921 Cantrell Rd
Suite 300
Little Rock, AR 72223-1701
Phone
(501) 907-6699
Fax
(501) 224-6481
NPI assigned
May 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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

Authorized official

Name
Dr. Julia Mortimer Watkins, M.D.NPI 1891738373
Title
President/Owner
Phone
(501) 907-6699

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X Primary

Addresses

Primary practice location

12921 Cantrell Rd
Suite 300
Little Rock, AR 72223-1701

Mailing address

12921 Cantrell Rd
Suite 300
Little Rock, AR 72223-1701
Phone (501) 907-6699

Other identifiers 1

IdentifierTypeStateIssuer
191367002MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110622000199 AR Part B Supplier - Clinic/Group Practice 8820276835 Receives reassigned benefits from 3 practitioners
Practice locations: Little Rock, AR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D1055968West Little Rock Women'S Center12921 Cantrell Road Suite 300, Little Rock, AR 72223Provider-performed microscopyJun 29, 2028

National Provider Directory

National Provider Directory

Locations

12921 Cantrell Rd
Ste 300
Little Rock, AR 72223
Phone (501) 224-6699

Practitioners & affiliated clinicians

Practitioners 7

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": "1304553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350518400000",
    "number": "1871885079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12921 CANTRELL RD",
            "address_2": "SUITE 300",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722231701",
            "telephone_number": "501-907-6699",
            "fax_number": "501-224-6481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12921 CANTRELL RD",
            "address_2": "SUITE 300",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722231701",
            "telephone_number": "501-907-6699",
            "fax_number": "501-224-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST LITTLE ROCK WOMENS CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-05",
        "last_updated": "2012-10-18",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "MORTIMER",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "501-907-6699",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191367002",
            "state": "AR"
        }
    ],
    "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 Oct 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.