JERRY DOUGLAS BYRUM (NPI# 1194789685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194789685 |
| Entity Type | Individual |
| Full Name | JERRY DOUGLAS BYRUM |
| Credential | MD |
| Practice Address |
904 Autumn Rd Suite 100 Little Rock AR 72211-3742 |
| Practice Telephone | 5012245437 |
| Practice Fax Number | 5012243473 |
| Mailing Telephone | 5012245437 |
| Mailing Fax Number | 5012243473 |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2011-11-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | C6800 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | QUALCHOICE | 11282000000 | 01 |
| AR | HEALTHLINK | 516264 | 01 |
| AR | 114501001 | 05 | |
| AR | AETNA | 4208764 | 01 |
| Street Address |
904 AUTUMN RD SUITE 100 |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72211-3742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053308940 | Park West Pharmacy | Pharmacy | 904 Autumn Rd, Suite 275, Little Rock, AR 72211-3702 | 2005-10-05 |
| 1578956223 | Emily Ann Fry | Nurse Practitioner | 904 Autumn Rd, Suite 200, Little Rock, AR 72211-3702 | 2015-03-05 |
| 1497046015 | John Philip Pounders Jr. | Family Medicine | 904 Autumn Rd, Suite 200, Little Rock, AR 72211-3702 | 2011-04-30 |
| 1851532071 | All for Kids Pediatric Clinic, P.a. | Pediatrics | 904 Autumn Rd, Suite 100, Little Rock, AR 72211-3702 | 2009-03-18 |
| 1629027818 | Autumn Road Family Practice, P.a | Clinic/Center | 904 Autumn Rd, Suite 200, Little Rock, AR 72211-3737 | 2006-05-08 |
| 1457318065 | Alison Richardson | Family Medicine | 904 Autumn Rd, Suite 200, Little Rock, AR 72211 | 2006-04-27 |
| 1871557157 | Dawn Martin | Pediatrics | 904 Autumn Rd, Suite100, Little Rock, AR 72211-3742 | 2006-04-14 |
| 1518921006 | Kimberly Skelley | Pediatrics | 904 Autumn Rd, Suite 100, Little Rock, AR 72211-3737 | 2006-04-13 |
| 1235192980 | Arkansas Health Group | Preferred Provider Organization | 904 Autumn Rd, Suite 100, Little Rock, AR 72211-3737 | 2006-04-11 |
| 1326001090 | Thomas Paulus | Pediatrics | 904 Autumn Rd, Suite 100, Little Rock, AR 72211-3737 | 2006-04-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760004618 | Samantha Lenore Hilborn | Behavior Technician | 1525 Merrill Drive Suite 100, Little Rock, AR 72211 | 2020-05-14 |
| 1003437740 | Centers for Youth and Families, Inc. | Community/Behavioral Health | 1521 Merrill Drive, Suite D220 and E200, Little Rock, AR 72211 | 2020-05-05 |
| 1962040568 | Erica N Taylor | Nurse Practitioner | 11800 Financial Center Parkway, Ste 290, Little Rock, AR 72211 | 2019-12-13 |
| 1568932119 | Katie Jones | Nurse Practitioner | 1children's Way, Little Rock, AR 72211 | 2018-11-27 |
| 1356828651 | Kayleigh King | Dietitian, Registered | 4 Shackleford Plz Ste 209, Little Rock, AR 72211 | 2018-07-19 |
| 1699283838 | Kara Elizabeth Simmons | Physician Assistant | 11215 Hermitage Rd Ste 103, Little Rock, AR 72211 | 2018-01-22 |
| 1194241463 | Wendy Newsam Pllc | Counselor | 1 Innwood Circle, Suite 107, Little Rock, AR 72211 | 2017-08-18 |
| 1861915159 | Sarah Renee Beall | Counselor | 10800 Financial Centre #290, Little Rock, AR 72211 | 2017-07-19 |
| 1457873127 | Restore Hope Counseling Center, Pllc | Counselor | One Innwood Circle, Suite 201, Little Rock, AR 72211 | 2017-07-13 |
| 1447707500 | University of Arkansas for Medical Sciences | Durable Medical Equipment & Medical Supplies | 601 Autumn Road, Little Rock, AR 72211 | 2016-09-07 |
| Find all providers in zip 72211 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437757630 | Kaylah Charles | Pediatrics | 36 Melinda Dr, Little Rock, AR 72209-3341 | 2020-10-12 |
| 1073006680 | Ezgi Saylam | Pediatrics | 15515 Capitol Hill Blvd Apt 616, Little Rock, AR 72223-7212 | 2018-06-08 |
| 1851889356 | Arkansas Pediatric Clinic, Pllc | Pediatrics | 16115 Saint Vincent Way Ste 320, Little Rock, AR 72223-3000 | 2018-04-30 |
| 1306377890 | Charles Pugh | Pediatrics | 1 Childrens Way # 519-19a, Little Rock, AR 72202-3500 | 2017-03-25 |
| 1225492929 | Kevin Weaver Jr. | Pediatrics | #1 Children's Way, Slot Ach 512-19a, Little Rock, AR 72202 | 2016-04-08 |
| 1255727756 | Stephen Nathaniel Epps | Pediatrics | 1 Childrens Way # 512-19b, Little Rock, AR 72202 | 2015-04-10 |
| 1902225220 | Hannah B Wilkins | Pediatrics | 1 Childrens Way # 512-1, Little Rock, AR 72202-3500 | 2014-04-15 |
| 1467871509 | Elaine Odiase | Pediatrics | 1 Childrens Way # 517-7, Little Rock, AR 72202-3500 | 2014-04-15 |
| 1245658376 | Natalie Nelson Burr | Pediatrics | 500 S University Ave Ste 400, Little Rock, AR 72205-5306 | 2014-04-05 |
| 1770907404 | Janece Hiegel | Pediatrics | 16112 Patriot Dr, Little Rock, AR 72212-2669 | 2014-02-17 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72211 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.