Organization Active NPI

Arkansas Family Medicine PA

  • Family Medicine Physician
  • Little Rock, AR
National Provider Identifier
1902340052
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ARKANSAS FAMILY MEDICINE PA
Practice address
15400 Chenal Pkwy
Suite 130
Little Rock, AR 72211-2016
Phone
(501) 725-7919
NPI assigned
Dec 8, 2016
Last updated
Dec 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Authorized official

Name
Allison Richardson
Title
Owner
Phone
(501) 725-7919

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

15400 Chenal Pkwy
Suite 130
Little Rock, AR 72211-2016

Mailing address

15400 Chenal Pkwy
Suite 130
Little Rock, AR 72211-2016
Phone (501) 725-7919

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170322001744 AR Part B Supplier - Clinic/Group Practice 3779868377 Receives reassigned benefits from 6 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
04D2129897Arkansas Family Medicine15400 Chenal Parkway, Ste 130, Little Rock, AR 72211Certificate of waiverApr 26, 2027

National Provider Directory

National Provider Directory

Locations

15400 Chenal Pkwy
Ste 130
Little Rock, AR 72211
Phone (501) 725-7919

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17584/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 6

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": "1481155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481155200000",
    "number": "1902340052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15400 CHENAL PKWY",
            "address_2": "SUITE 130",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722112016",
            "telephone_number": "501-725-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15400 CHENAL PKWY",
            "address_2": "SUITE 130",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722112016",
            "telephone_number": "501-725-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS FAMILY MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-08",
        "last_updated": "2016-12-08",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-725-7919"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 8, 2016; 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.