NPIMap

Individual provider Active NPI

John Brett Ironside, M.D.

  • Neurology Physician
  • Little Rock, AR
National Provider Identifier
1891727855
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
C8268 Issued in AR
Practice address
10001 Lile Dr
Little Rock, AR 72205-6217
Phone
(501) 227-8000
Fax
(501) 227-7362
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X C8268 AR Primary

Addresses

Primary practice location

10001 Lile Dr
Little Rock, AR 72205-6217

Mailing address

10001 Lile Dr
Little Rock, AR 72205-6217
Phone (501) 227-8000

Other identifiers 2

IdentifierTypeStateIssuer
686523OtherARMEDICARE ID# FOR CHI ST. VINCENT LITTLE ROCK DIAGNOSTIC CLINIC
129100001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040428000906 AR Practitioner - Neurology 2961499223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Arkansas College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical GroupGroup PAC ID 5698758803, 237 clinicians
Fands Physical Therapy, IncGroup PAC ID 7810898459, 217 clinicians

Practice addresses (Care Compare)

10001 Lile Dr
Little Rock, AR 72205-6217
Phone (501) 227-8000

1414 Hwy 71 N
Alma, AR 72921-4723
Phone (479) 632-0321

7709 Hwy 107
Sherwood, AR 72120-4661
Phone (501) 552-7269

Hospital & facility affiliations

  • CHI St. Vincent Hospital Hot Springs Hospital, Hot Springs, AR, CCN 040026
  • CHI-St Vincent Infirmary Hospital, Little Rock, AR, CCN 040007
  • Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114
  • Baptist Health Rehabilitation Institute Inpatient rehabilitation facility, Little Rock, AR, CCN 043026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C8268ARMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group Neurology CurrentSince Sep 1, 2018 Accepting new patients
De Queen Medical Center Inc Past Accepting new patients
Arkansas Health Group Past Accepting new patients
Neuroscience Associates PA Neurology Past Accepting new patients
Arkansas Health Group Past Accepting new patients

Locations

10001 Lile Dr
Little Rock, AR 72205
Phone (501) 227-8000

16221 Saint Vincent Way
Little Rock, AR 72223
Phone (501) 221-0888

Interoperability endpoints

  • Direct secure messaging: john.ironside.p1@direct.chi-lrdc.nextgenshare.com
  • Direct secure messaging: jironside457041@direct.stlukeshealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1891727855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 LILE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056217",
            "telephone_number": "501-227-8000",
            "fax_number": "501-227-7362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 LILE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056217",
            "telephone_number": "501-227-8000",
            "fax_number": "501-227-7362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRONSIDE",
        "first_name": "JOHN",
        "middle_name": "BRETT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AR",
            "license": "C8268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID# FOR CHI ST. VINCENT LITTLE ROCK DIAGNOSTIC CLINIC",
            "identifier": "686523",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129100001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.