Individual provider Active NPI

Prabhat Mishra, M.D.

  • Pediatric Anesthesiology Physician
  • Little Rock, AR
National Provider Identifier
1972867240
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
E-13412 Issued in AR
Practice address
1 Childrens Way # 203
Little Rock, AR 72202-3500
Phone
(501) 364-1100
Fax
(501) 364-4082
NPI assigned
Jul 1, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X 2012018936 MO
Pediatric Anesthesiology Physician 207LP3000X 26070 MS
Pediatric Anesthesiology Physician 207LP3000X E-13412 AR Primary

Addresses

Primary practice location

1 Childrens Way # 203
Little Rock, AR 72202-3500

Mailing address

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

Other practice location 1

4301 W Markham St # 515
Little Rock, AR 72205-7101
Phone (501) 364-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MS, AR, TN4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20170817001761 FL Practitioner - Anesthesiology 6709158264 Reassigns benefits to 2 organizations
I20181112001600 MS Practitioner - Anesthesiology 6709158264 Reassigns benefits to 1 organization
I20200729001408 AR Practitioner - Anesthesiology 6709158264 Reassigns benefits to 3 organizations
I20260217000117 TN Practitioner - Anesthesiology 6709158264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Miami, LM Miller School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

255 W Michigan Ave
Jackson, MI 49201-2218

850 Poplar Ave
BLDG 2
Memphis, TN 38105-4607

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-13412ARMDPediatric Anesthesiology Physician
2012018936MOMDPediatric Anesthesiology Physician
26070MSMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Jul 9, 2020 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Oct 12, 2018 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 9, 2020 Accepting new patients
Arkansas Childrens Hospital CurrentSince Jul 9, 2020 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Jan 30, 2018 Accepting new patients
Arkansas Children'S Hospital CurrentSince Jul 9, 2020 Accepting new patients
Ut Lebonheur Pediatric Specialists, Inc. CurrentSince Jan 26, 2026 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Oct 12, 2018 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
US Anesthesia Partners of Florida Inc. CurrentSince Jun 21, 2017 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Jan 30, 2018 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 9, 2020 Accepting new patients

Locations

1 Childrens Way
#203
Little Rock, AR 72202
Phone (501) 364-2180

1 Childrens Way
Ste 653
Little Rock, AR 72202

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

4301 W Markham St
#515
Little Rock, AR 72205
Phone (501) 603-1656

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

848 Adams Ave
Memphis, TN 38103
Phone (901) 287-5437

100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1341100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1972867240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 203",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St # 515",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-364-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISHRA",
        "first_name": "PRABHAT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-01",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "MO",
            "license": "2012018936",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "MS",
            "license": "26070",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "AR",
            "license": "E-13412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.