NPIMap

Individual provider Active NPI

Ladly Abraham, MD

  • Pulmonary Disease Physician
  • Conway, AR
National Provider Identifier
1972537090
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
E2894 Issued in AR
Practice address
650 United Dr Ste 200
Conway, AR 72032-7001
Phone
(501) 852-5500
Fax
(501) 358-6196
NPI assigned
Jul 11, 2006
Last updated
Mar 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X E2894 AR Primary

Addresses

Primary practice location

650 United Dr Ste 200
Conway, AR 72032-7001

Mailing address

650 United Dr Ste 200
Conway, AR 72032-7001
Phone (501) 852-5500

Other identifiers 1

IdentifierTypeStateIssuer
145047001MedicaidAR

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
I20110125000127 AR Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Sleep Medicine 2860577038 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Sleep Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

625 United Dr
Suite 360
Conway, AR 72032-7831
Phone (501) 358-6206

650 United Dr
Suite 200
Conway, AR 72032-7001
Phone (501) 852-5500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E2894ARMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group Pulmonary Disease CurrentSince Jul 18, 2022 Accepting new patients
Central Arkansas Sleep Health, LLC CurrentSince Jun 12, 2017 Accepting new patients
Intensivist Group, LLC Pulmonary Disease Current Accepting new patients
Intensivist Group,LLC Pulmonary Disease CurrentSince Nov 14, 2015 Accepting new patients
Arkansas Complete Care CurrentSince Apr 17, 2024 Accepting new patients
Arkansas Health Group CurrentSince Jul 18, 2022 Accepting new patients
Radiology Associates PA Past Accepting new patients

Locations

625 United Dr
Ste 360
Conway, AR 72032
Phone (501) 358-6206

650 United Dr
Ste 200
Conway, AR 72032
Phone (501) 291-5759

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

Interoperability endpoints

  • Direct secure messaging: ladly.abraham@cal.eclinicaldirectplus.com

Organizations & group practices 7

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 10

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1972537090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 UNITED DR STE 200",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720327001",
            "telephone_number": "501-852-5500",
            "fax_number": "501-358-6196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 UNITED DR STE 200",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720327001",
            "telephone_number": "501-852-5500",
            "fax_number": "501-358-6196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "LADLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AR",
            "license": "E2894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145047001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.