LITTLE ROCK DIALYSIS, INC. (NPI# 1558473454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558473454 |
| Entity Type | Organization |
| Organization Name | LITTLE ROCK DIALYSIS, INC. |
| Other Organization Name | ARKANSAS DIALYSIS |
| Practice Address |
4275 E Mccain Blvd North Little Rock AR 72117-2516 |
| Practice Telephone | 5019459455 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARK FAWCETT (TREASURER) |
| Authorized Official Telephone | 7814029000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| ARKANSAS DIALYSIS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720190622 | Little Rock Dialysis, Inc. | Clinic/Center | 2101 Congo Rd, Benton, AR 72015-2750 | 2006-08-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LITTLE ROCK DIALYSIS, INC. | 10310 W Markham St Ste 197, Little Rock, AR 72205-1581 |
| Street Address |
4275 E MCCAIN BLVD |
| City | NORTH LITTLE ROCK |
| State | AR |
| Zip Code | 72117-2516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184225062 | Lisa Diane Wilson | Pharmacist | 5600 Landers Road, Sherwood, AR 72117 | 2020-11-05 |
| 1306475470 | Amir Amidi | Student in an Organized Health Care Education/Training Program | Baptist Health Family Medicine Residency Clinic, 3201 Springhill Dr., Suite 300, North Little Rock, AR 72117 | 2020-04-02 |
| 1699238147 | Achmed Munir Turay | Student in an Organized Health Care Education/Training Program | Baptist Health Medical Center- North Little Rock, 3333 Springhill Drive, Little Rock, AR 72117 | 2019-04-11 |
| 1548712227 | Arkansas Outpatient Surgery Center, LLC | Clinic/Center | 4331 W. 43rd, North Little Rock, AR 72117 | 2016-10-28 |
| 1982053286 | Amy Rainey | Nurse Practitioner | 3550 Springhill Dr, North Little Rock, AR 72117 | 2016-06-07 |
| 1558764159 | Premier Pharmacy Care LLC | Pharmacy | 760 Michaela Dr., North Little Rock, AR 72117 | 2014-09-27 |
| 1225458813 | Jennifer Lynn Duroy | Obstetrics & Gynecology | 3343 Springhill Dr Ste 3010, North Little Rock, AR 72117 | 2014-04-22 |
| 1285053686 | Jonathan Nicholas Chang | Obstetrics & Gynecology | 3343 Springhill Dr Ste 1005, North Little Rock, AR 72117 | 2014-04-14 |
| 1760820575 | Stefan Ceru Hemmings | Internal Medicine | 3401 Springhill Dr Ste 325, North Little Rock, AR 72117 | 2013-06-13 |
| 1104260629 | Pain & Ortho Products, LLC | Durable Medical Equipment & Medical Supplies | 4628 East 43rd, N Little Rock, AR 72117 | 2013-04-26 |
| Find all providers in zip 72117 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588102610 | Matheson Dialysis LLC | Clinic/Center | 9022 Landers Rd Ste E, North Little Rock, AR 72117-1599 | 2017-02-09 |
| 1447556048 | Capes Dialysis LLC | Clinic/Center | 3401 Springhill Dr, Ste 190, North Little Rock, AR 72117-2924 | 2011-01-31 |
| 1497977714 | Little Rock Dialysis Centers LLC | Clinic/Center | 4505 E Mccain Blvd, North Little Rock, AR 72117-2902 | 2007-05-03 |
| 1710075056 | Dialysis Centers of Arkansas, Pa | Clinic/Center | 4509 E Mccain Blvd, North Little Rock, AR 72117-2902 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092597 | Fort Smith Regional Dialysis Center, LLC | Clinic/Center | 256 Northridge Drive E, Van Buren, AR 72956 | 2020-08-06 |
| 1073010518 | Toltec Dialysis LLC | Clinic/Center | 2630 Donaghey Ave, Conway, AR 72032-0000 | 2018-04-11 |
| 1871031211 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 115 E Peddicord St, Dermott, AR 71638-2314 | 2017-02-06 |
| 1821455494 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 505 Saint Mary St, Lake Village, AR 71653-1722 | 2016-01-27 |
| 1912399601 | Ozark Dialysis LLC | Clinic/Center | 404 Camp Rd, Pocahontas, AR 72455-1487 | 2015-03-04 |
| 1447640917 | Fidelity Home Dialysis Corporation | Clinic/Center | 9421 W Markham St, Little Rock, AR 72205-2240 | 2015-02-04 |
| 1386053296 | Arkansas Staff Assisted Hemodialysis,inc | Clinic/Center | 321 Terry Pond Cv, White Hall, AR 71602-8212 | 2014-08-05 |
| 1609291202 | Little Rock Renal Services LLC | Clinic/Center | 1910 John Barrow Rd, Little Rock, AR 72204-1448 | 2014-02-19 |
| 1396178471 | Renal Treatment Centers - Southeast Lp | Clinic/Center | 6115 Baseline Rd, Ste 100, Little Rock, AR 72209 | 2013-08-13 |
| 1922346147 | Dialysis Clinic Inc. | Clinic/Center | 2800 W 10th St, Suite 510, Little Rock, AR 72204-2206 | 2013-01-23 |
| Find all providers with the same taxonomy | ||||
| City | NORTH LITTLE ROCK |
| Zip Code | 72117 |
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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.