Individual provider Active NPI

Marshall William Witt, PA-C

  • Physician Assistant
  • Little Rock, AR
National Provider Identifier
1881470805
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1204 Issued in AR
Practice address
9601 Baptist Health Dr Ste 860
Little Rock, AR 72205-6375
Phone
(501) 975-7456
Fax
(501) 978-1822
NPI assigned
Sep 5, 2023
Last updated
May 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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-1204 AR Primary

Addresses

Primary practice location

9601 Baptist Health Dr Ste 860
Little Rock, AR 72205-6375

Mailing address

4261 Stockton Dr Ste Ll100
North Little Rock, AR 72117-2966
Phone (501) 975-7456

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
I20231024003539 AR Practitioner - Physician Assistant 3870949076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Arkansas College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Dermatology PLLCGroup PAC ID 2466418470, 20 clinicians

Practice addresses (Care Compare)

15506 Hwy 5
Suite a
Cabot, AR 72023-7695
Phone (501) 941-3101

2645 Hwy 25B N
Heber Springs, AR 72543-6305
Phone (501) 362-3100

4261 Stockton Dr
North Little Rock, AR 72117-2916

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1881470805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4261 STOCKTON DR STE LL100",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172966",
            "telephone_number": "501-975-7456",
            "fax_number": "501-978-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 BAPTIST HEALTH DR STE 860",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056375",
            "telephone_number": "501-975-7456",
            "fax_number": "501-978-1822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITT",
        "first_name": "MARSHALL",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-05",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.