NPIMap

Organization Active NPI

Arkansas Surgical Hospital, LLC

  • General Acute Care Hospital
  • North Little Rock, AR
National Provider Identifier
1942260609
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
AR4280 Issued in AR
Legal business name
ARKANSAS SURGICAL HOSPITAL, LLC
Practice address
5201 Northshore Drive
North Little Rock, AR 72118-5312
Phone
(501) 748-8000
Fax
(501) 748-8173
NPI assigned
Mar 27, 2006
Last updated
Sep 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Authorized official

Name
Mr. Christopher Brian Fowler
Title
Ceo
Phone
(501) 748-8089

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X AR4280 AR Primary

Addresses

Primary practice location

5201 Northshore Drive
North Little Rock, AR 72118-5312

Mailing address

5201 Northshore Drive
North Little Rock, AR 72118-5312
Phone (501) 748-8000

Other identifiers 1

IdentifierTypeStateIssuer
157876105MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050421000168 AR Part A Provider - Hospital 5496793390 Practice locations: North Little Rock, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942260609. Details of each certification follow.

Hospital certification: CCN 040147

Legal name
ARKANSAS SURGICAL HOSPITAL LLC
Doing business as
ARKANSAS SURGICAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
May 9, 2005
Last certification
Apr 3, 2024
Beds
47
Ownership / control type
Physician ownership
Organization structure
LLCProprietary
Enrollment address
5201 Northshore Dr
North Little Rock, AR 72118-5312
Other Hospital Practice Location
Hospital subgroups
Acute care, Specialty hospital

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Arkansas Surgical HospitalCCN 040147 · All quality measures
Type
Acute Care Hospitals
Ownership
Physician
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Arkansas Surg Hosp LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
James Z Mason Individual 5% Or Greater Indirect Ownership Interest Apr 21, 2005 5.51%
Brad a Thomas Individual Corporate Director Jan 1, 2022 3%
Operational/Managerial Control Jan 1, 2022 3%
William S Bowen Individual Corporate DirectorBoard Member Jan 1, 2015 4.41%
Operational/Managerial ControlBoard Member Jan 1, 2015 4.41%
Christopher Brian Fowler Individual Corporate OfficerCeo Jan 1, 2020
W-2 Managing EmployeeCeo Dec 1, 2016
Kenneth a Martin Individual 5% Or Greater Indirect Ownership Interest Jan 22, 2015 5.51%
Andrew Mitchell Covington Individual Corporate OfficerCfo Jan 1, 2020
W-2 Managing EmployeeCfo Jan 1, 2020
Reza Shahim Individual Corporate DirectorBoard Member Jan 1, 2015 4.2%
Operational/Managerial ControlBoard Member Jan 1, 2015 4.2%
Ar Surgical Holdings, LLC Organization, North Little Rock, AR Created for acquisition, For-profit 5% Or Greater Direct Ownership Interest Jan 1, 2015 49%
William F Hefley Individual Corporate Director Jan 1, 2022 4.41%
Operational/Managerial Control Jan 1, 2022 4.41%
Medical Facilities USA Holdings Inc Organization, Scottsdale, AZ For-profit 5% Or Greater Direct Ownership Interest Jan 1, 2015 51%

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 120

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 120

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1942260609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 NORTHSHORE DRIVE",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721185312",
            "telephone_number": "501-748-8000",
            "fax_number": "501-748-8173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 NORTHSHORE DRIVE",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721185312",
            "telephone_number": "501-748-8000",
            "fax_number": "501-748-8173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS SURGICAL HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "501-748-8089",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "AR",
            "license": "AR4280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157876105",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.