NPIMap

Individual provider Active NPI

Charles W Clogston, M.D.

  • Cardiovascular Disease Physician
  • Little Rock, AR
National Provider Identifier
1962449728
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
E0428 Issued in AR
Practice address
10100 Kanis Rd
Little Rock, AR 72205-6202
Phone
(501) 255-6000
Fax
(501) 255-6400
NPI assigned
Jun 1, 2006
Last updated
Mar 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X E0428 AR Primary
Nuclear Cardiology Physician 207UN0901X E0428 AR

Addresses

Primary practice location

10100 Kanis Rd
Little Rock, AR 72205-6202

Mailing address

10100 Kanis Rd
Little Rock, AR 72205-6202
Phone (501) 255-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050727001119 AR Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2264460690 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10100 Kanis Rd
Little Rock, AR 72205-6202
Phone (501) 255-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Infirmary Medical Center CurrentSince Dec 1, 2006 Accepting new patients
Heart Clinic Arkansas Cardiovascular Disease Current Accepting new patients
St. Vincent Infirmary Medical Center Current Accepting new patients
St. Vincent Infirmary Medical Center Current Accepting new patients
Baptist Health Cardiovascular Disease CurrentSince Sep 1, 2010 Accepting new patients
St Vincent Infirmary Medical Center CurrentSince Dec 1, 2006 Accepting new patients
Baptist Health CurrentSince Sep 1, 2010 Accepting new patients
St. Anthony's Hospital Association Cardiovascular Disease Past Accepting new patients

Locations

909 Unity Rd
Crossett, AR 71635
Phone (870) 364-5100

10100 Kanis Rd
Little Rock, AR 72205
Phone (501) 255-6000

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

9601 Baptist Health Dr
Little Rock, AR 72205
Phone (501) 202-3995

9601 Interstate 630
Little Rock, AR 72205
Phone (501) 202-2300

1708 N Buerkle St
Stuttgart, AR 72160
Phone (870) 659-8050

Interoperability endpoints

  • Direct secure messaging: cclogston456196@direct.stlukeshealth.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1962449728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 KANIS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056202",
            "telephone_number": "501-255-6000",
            "fax_number": "501-255-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 KANIS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056202",
            "telephone_number": "501-255-6000",
            "fax_number": "501-255-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOGSTON",
        "first_name": "CHARLES",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AR",
            "license": "E0428",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "AR",
            "license": "E0428",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.