Individual provider Active NPI

Matthew Wesley Harrison, MD

  • Emergency Medicine Physician
  • Little Rock, AR
National Provider Identifier
1912403445
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E-14003 Issued in AR
Practice address
1701 S Shackleford Rd
Little Rock, AR 72211-4335
Phone
(501) 219-7000
NPI assigned
Apr 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E-14003 AR Primary

Addresses

Primary practice location

1701 S Shackleford Rd
Little Rock, AR 72211-4335

Mailing address

PO Box 165257
Little Rock, AR 72216-5257

Other practice location 1

1901 Encore Way
Benton, AR 72019-8896
Phone (501) 213-4500

Other identifiers 1

IdentifierTypeStateIssuer
E-14003OtherARMEDICAL LICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210726003608 AR Practitioner - Emergency Medicine 0042566689 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Heart Hospital LLCGroup PAC ID 6002838653, 85 clinicians

Practice addresses (Care Compare)

1701 S Shackleford Rd
Little Rock, AR 72211-4335

7 Shackleford W Blvd
Little Rock, AR 72211-3886
Phone (501) 664-5860

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Heart Hospital, LLC CurrentSince Jul 1, 2021 Accepting new patients
Arkansas Heart Hospital, LLC CurrentSince Jul 1, 2021 Accepting new patients
Greenbrier Emergency Services, Inc. Emergency Medicine CurrentSince Mar 1, 2022 Accepting new patients

Locations

1901 Encore Way
Bryant, AR 72019
Phone (501) 213-4500

1701 S Shackleford Rd
Little Rock, AR 72211
Phone (501) 219-7000

7 Shackleford West Blvd
Little Rock, AR 72211
Phone (501) 614-3671

3333 Springhill Dr
North Little Rock, AR 72117
Phone (501) 202-3000

Organizations & group practices 3

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 3

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": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1912403445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 165257",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722165257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 S SHACKLEFORD RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114335",
            "telephone_number": "501-219-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 Encore Way",
            "address_purpose": "LOCATION",
            "city": "Benton",
            "state": "AR",
            "postal_code": "720198896",
            "country_code": "US",
            "telephone_number": "501-213-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "MATTHEW",
        "middle_name": "WESLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2023-03-07",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-14003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "E-14003",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.