EXECUTIVE SURGERY CENTER OF LITTLE ROCK, LLC (NPI# 1386177376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386177376 |
| Entity Type | Organization |
| Organization Name | EXECUTIVE SURGERY CENTER OF LITTLE ROCK, LLC |
| Practice Address |
11220 Executive Center Dr Suite 100 Little Rock AR 72211-4320 |
| Practice Telephone | 5013122121 |
| Practice Fax Number | 5013122330 |
| Mailing Telephone | 5013122121 |
| Mailing Fax Number | 5013122330 |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2020-10-13 |
| Authorized Official Name | MRS. BRITNEY DESHAE SMITH (ADMINISTRATOR) |
| Authorized Official Telephone | 5013122121 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 225821128 | 05 | |
| FIRST HEALTH | 3130254 | 01 | |
| AETNA COVENTRY | 970544 | 01 | |
| AETNA | 6098850 | 01 |
| Street Address |
11220 EXECUTIVE CENTER DR SUITE 100 |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72211-4320 |
| 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 | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629675285 | Orthoarkansas Spine Institute Procedure Center LLC | Clinic/Center | 800 Fair Park Blvd Ste 300, Little Rock, AR 72204-1720 | 2020-10-07 |
| 1679001028 | Centerview Surgery Center, LLC | Clinic/Center | 1310 Centerview Dr, Little Rock, AR 72211-4349 | 2017-05-30 |
| 1043625221 | Interventional Surgery Institute of Little Rock, LLC | Clinic/Center | 9 Freeway Drive, Suite A, Little Rock, AR 72204 | 2014-06-25 |
| 1588876817 | Freeway Surgery Center LLC | Clinic/Center | 5800 West Tenth Street, Suite 206, Little Rock, AR 72204 | 2007-05-07 |
| 1487776365 | Seymour Operations LLC | Clinic/Center | 200 N Van Buren St, Little Rock, AR 72205-3650 | 2007-04-04 |
| 1588603351 | Physician's Day Surgery Center | Clinic/Center | 17200 Chenal Pkwy Ste 440, Little Rock, AR 72223-5970 | 2006-06-06 |
| 1063470730 | Endoscopy Center of Arkansas, LLC | Clinic/Center | 1024 N University Ave, Little Rock, AR 72207-6347 | 2006-05-03 |
| 1659340404 | Little Rock Surgery Center, LLC | Clinic/Center | 8820 Knoedl Ct, Little Rock, AR 72205-4600 | 2006-03-15 |
| 1215919329 | Gastro-intestinal Center Inc | Clinic/Center | 405 N University Ave, Little Rock, AR 72205-3108 | 2005-11-15 |
| 1861488587 | Little Rock Outpatient Surgery Center, LLC | Clinic/Center | 8907 Kanis Rd, Ste. 100, Little Rock, AR 72205-6449 | 2005-09-27 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72211 |
Please comment or provide details below to improve the information on EXECUTIVE SURGERY CENTER OF LITTLE ROCK, LLC.
| 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.