Organization Active NPI

Little Rock Cancer Clinic, P.a.

  • Hematology & Oncology Physician
  • Little Rock, AR
National Provider Identifier
1902832330
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
LITTLE ROCK CANCER CLINIC, P.A.
Practice address
500 S University Ave
Suite 811
Little Rock, AR 72205-5302
Phone
(501) 661-1822
Fax
(501) 666-0266
NPI assigned
Jun 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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

Authorized official

Name
Luis Reyes
Title
Office Manager
Phone
(501) 661-1822

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

500 S University Ave
Suite 811
Little Rock, AR 72205-5302

Mailing address

500 S University Ave Ste 606
Little Rock, AR 72205-5308
Phone (501) 661-1822

Other identifiers 5

IdentifierTypeStateIssuer
5239121OtherAETNA
130483002MedicaidAR
472130OtherHEALTHLINK PPO
1902832330OtherMERCY HEALTH PLANS
04D0922485OtherC.L.I.A. NUMBER FOR LAB

National Provider Directory

National Provider Directory

Locations

500 S University Ave
Ste 811
Little Rock, AR 72205
Phone (501) 661-1822

Practitioners & affiliated clinicians

Practitioners 1

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": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578873600000",
    "number": "1902832330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE STE 606",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055308",
            "telephone_number": "501-661-1822",
            "fax_number": "501-666-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE",
            "address_2": "SUITE 811",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055302",
            "telephone_number": "501-661-1822",
            "fax_number": "501-666-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE ROCK CANCER CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "501-661-1822"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5239121",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130483002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PPO",
            "identifier": "472130",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH PLANS",
            "identifier": "1902832330",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "C.L.I.A. NUMBER FOR LAB",
            "identifier": "04D0922485",
            "state": null
        }
    ],
    "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 Jan 13, 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.