LITTLE ROCK PEDIATRIC GROUP (NPI# 1457396780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457396780 |
| Entity Type | Organization |
| Organization Name | LITTLE ROCK PEDIATRIC GROUP |
| Other Organization Name | LITTLE ROCK PEDIATRIC CLINIC |
| Practice Address |
500 S University Ave Suite 400 Little Rock AR 72205-5302 |
| Practice Telephone | 5016644044 |
| Practice Fax Number | 5016644064 |
| Mailing Telephone | 5016644044 |
| Mailing Fax Number | 5016644064 |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JO LYNNE VARNER (ADMINISTRATOR) |
| Authorized Official Telephone | 5016644044 |
| Authorized Official Credential | MHSA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Little Rock Pediatric Clinic | Doing Business As Name - Organization |
| Street Address |
500 S UNIVERSITY AVE SUITE 400 |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72205-5302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083618318 | Tammy Lea Dunn | Specialist | 500 S University Ave, Ste 606, Little Rock, AR 72205-5342 | 2005-05-31 |
| 1043843915 | Jeff Pinto | Nurse Practitioner | 500 S University Ave, Little Rock, AR 72205-5302 | 2020-02-19 |
| 1821534835 | Brittney Denell Lisenbey | Nurse Practitioner | 500 S University Ave, Suite 515, Little Rock, AR 72205-5302 | 2017-01-13 |
| 1245687029 | Arkansas Breast Surgery Corp. | Surgery | 500 S University Ave, Suite 219, Little Rock, AR 72205-5302 | 2016-05-20 |
| 1497128722 | Alexandra Blue Gonzalez | Physician Assistant | 500 S University Ave, Little Rock Dermatology Clinic Suite 301, Little Rock, AR 72205-5302 | 2015-11-09 |
| 1609251842 | Pediatric Physicians Group, Pllc | Pediatrics | 500 S University Ave, Suite 200, Little Rock, AR 72205-5302 | 2015-07-29 |
| 1609260157 | Gabriel M Peal M.d,.,pa | Specialist | 500 S University Ave, Suite 221, Little Rock, AR 72205-5302 | 2015-03-23 |
| 1376947804 | Blood and Cancer Institute of Little Rock | Clinical Medical Laboratory | 500 S University Ave, Suite 808, Little Rock, AR 72205-5302 | 2014-10-13 |
| 1457765182 | Jena Gray | Registered Nurse | 500 S University Ave, Suite 505, Little Rock, AR 72205-5302 | 2014-06-20 |
| 1952723397 | Jesse Davis | Registered Nurse | 500 S University Ave, Ste 505, Little Rock, AR 72205-5302 | 2014-01-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932719465 | Darleisha Renee Stigall | Behavior Technician | 1210 Aldersdate Rd, Little Rock, AR 72205 | 2020-08-10 |
| 1316563638 | Unknown Amisha | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot #634, University of Arkansas, Little Rock, AR 72205 | 2020-06-23 |
| 1225667272 | Ann-marie Frances Hayre | Student in an Organized Health Care Education/Training Program | 4310 West Markham, Slot 589, Little Rock, AR 72205 | 2020-04-02 |
| 1952930075 | Alexandria Leigh Smith | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot 531, Little Rock, AR 72205 | 2020-04-02 |
| 1093353922 | Phil Fagala | Pharmacist | 614 North Beechwood, Little Rock, AR 72205 | 2019-12-10 |
| 1295391688 | Home To Community Living, Inc | Physical Therapist | 10201 W Markham Street Pulaski, Little Rock, AR 72205 | 2019-05-12 |
| 1669933693 | Sandy Louise Webb | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 530, Little Rock, AR 72205 | 2019-03-31 |
| 1457812828 | Vincent Battafarano | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 602, Little Rock, AR 72205 | 2019-03-28 |
| 1063978922 | Franks Pediatric Occupational Therapy LLC | Occupational Therapist | 5516 C St, Little Rock, AR 72205 | 2019-02-15 |
| 1497210199 | Integrative Counseling Center LLC | Counselor | 10515 W Markham St Ste D3, Little Rock, AR 72205 | 2019-02-06 |
| Find all providers in zip 72205 | ||||
| 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 | 72205 |
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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.