Individual provider Active NPI

Donald L Patrick, MD

  • General Practice Physician
  • Searcy, AR
National Provider Identifier
1962466748
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
R-2139 Issued in AR
Practice address
305 Rodgers Dr
Searcy, AR 72143-7432
Phone
(501) 203-0857
Fax
(501) 203-0864
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X R2139 AR
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X K8415 TX
General Practice Physician 208D00000X R-2139 AR Primary

Addresses

Primary practice location

305 Rodgers Dr
Searcy, AR 72143-7432

Mailing address

PO Box 497
Augusta, AR 72006-0497
Phone (870) 347-3524

Other practice location 1

2401 S 31st St
Temple, TX 76508-0001
Phone (254) 724-2111

Other identifiers 1

IdentifierTypeStateIssuer
105640001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R2139ARMDVascular Surgery Physician
R-2139ARMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group General Practice Current Accepting new patients

Locations

2900 Hawkins Dr
Searcy, AR 72143
Phone (501) 278-2800

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1962466748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 497",
            "city": "AUGUSTA",
            "state": "AR",
            "postal_code": "720060497",
            "telephone_number": "870-347-3524",
            "fax_number": "870-347-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 RODGERS DR",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721437432",
            "telephone_number": "501-203-0857",
            "fax_number": "501-203-0864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 S 31st St",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765080001",
            "country_code": "US",
            "telephone_number": "254-724-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "DONALD",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AR",
            "license": "R2139",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "K8415",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AR",
            "license": "R-2139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105640001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Searcy, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.