Individual provider Active NPI

Jonathon D Palmer, MD

  • Emergency Medicine Physician
  • Little Rock, AR
National Provider Identifier
1982704516
Registry record updated Mar 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E-3664 Issued in AR
Practice address
4301 W Markham St
Uams #783
Little Rock, AR 72205-7101
Phone
(501) 686-8000
Fax
(501) 603-1436
NPI assigned
Sep 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E-3664 AR Primary

Addresses

Primary practice location

4301 W Markham St
Uams #783
Little Rock, AR 72205-7101

Mailing address

4301 W Markham St
Uams #783
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other identifiers 4

IdentifierTypeStateIssuer
P00351560OtherARRAILROAD MEDICARE
E3664OtherARTRICARE
149498001MedicaidAR
P00037818OtherARRAILROAD MCARE THRU WCMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070113000011 AR Practitioner - Emergency Medicine 7214903657 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-3664ARMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
White County Medical Center Emergency Medicine CurrentSince Jul 24, 2009 Accepting new patients
Baptist Medcare, Inc Emergency Medicine CurrentSince May 2, 2014 Accepting new patients
White County Medical Center CurrentSince Jul 24, 2009 Accepting new patients
Correct Care, Inc. Emergency Medicine Past Accepting new patients

Locations

3050 Twin Rivers Dr
Arkadelphia, AR 71923
Phone (501) 202-2300

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

3214 E Race Ave
Searcy, AR 72143
Phone (501) 268-6121

Organizations & group practices 4

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": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364515200000",
    "number": "1982704516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST",
            "address_2": "UAMS #783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-603-1436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST",
            "address_2": "UAMS #783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-603-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "JONATHON",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2013-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-3664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00351560",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "E3664",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149498001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCARE THRU WCMC",
            "identifier": "P00037818",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.