Organization Active NPI

Pleasant Valley Ophthalmology, PLLC

  • Ophthalmology Physician
  • Little Rock, AR
National Provider Identifier
1912949785
Registry record updated Oct 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
PLEASANT VALLEY OPHTHALMOLOGY, PLLC
Practice address
11825 Hinson Rd
Ste. 103
Little Rock, AR 72212-3404
Phone
(501) 223-3937
Fax
(501) 223-8656
NPI assigned
Jun 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2014

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

Authorized official

Name
Dr. Susan Diane Blair, M.D.
Title
Owner Physician
Phone
(501) 223-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

11825 Hinson Rd
Ste. 103
Little Rock, AR 72212-3404

Mailing address

11825 Hinson Rd
Ste. 103
Little Rock, AR 72212-3404
Phone (501) 223-3937

Other identifiers 1

IdentifierTypeStateIssuer
CJ3133OtherARRR MEDICARE GROUP #

National Provider Directory

National Provider Directory

Locations

11825 Hinson Rd
Ste 103
Little Rock, AR 72212
Phone (501) 223-3937

Practitioners & affiliated clinicians

Practitioners 2

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": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414368000000",
    "number": "1912949785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11825 HINSON RD",
            "address_2": "STE. 103",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722123404",
            "telephone_number": "501-223-3937",
            "fax_number": "501-223-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11825 HINSON RD",
            "address_2": "STE. 103",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722123404",
            "telephone_number": "501-223-3937",
            "fax_number": "501-223-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEASANT VALLEY OPHTHALMOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2014-10-27",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "501-223-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP #",
            "identifier": "CJ3133",
            "state": "AR"
        }
    ],
    "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 Oct 27, 2014; 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.