PEDIATRIX MEDICAL GROUP OF ARKANSAS PA (NPI# 1780781492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780781492 |
| Entity Type | Organization |
| Organization Name | PEDIATRIX MEDICAL GROUP OF ARKANSAS PA |
| Other Organization Name | PEDIATRIX MEDICAL GROUP OF NEBRASKA |
| Practice Address |
9601 Interstate 630 Little Rock AR 72205-7202 |
| Mailing Address |
1500 Concord Ter Sunrise FL 33323-2815 |
| Practice Telephone | 8777374546 |
| Mailing Telephone | 8002433839 |
| Mailing Fax Number | 8446862961 |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2018-01-24 |
| Authorized Official Name | JORGE I. DEL TORO (PRESIDENT/DIRECTOR) |
| Authorized Official Telephone | 8002433839 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 207VM0101X |
Obstetrics & Gynecology Specialization: Maternal & Fetal Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 133312002 | 05 |
| Other Name | Type Code |
|---|---|
| Pediatrix Medical Group of Nebraska | Doing Business As Name - Organization |
| Street Address |
9601 INTERSTATE 630 |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72205-7202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417957200 | Select Specialty Hospital - Little Rock/bmc Inc | Long Term Care Hospital | 9601 Interstate 630, Exit 7, 10th Floor, Little Rock, AR 72205-7202 | 2005-07-22 |
| 1619386778 | Mary Roberts | Registered Nurse | 9601 Interstate 630, Little Rock, AR 72205-7202 | 2014-08-03 |
| 1477968030 | Casey G Polk | Nurse Anesthetist, Certified Registered | 9601 Interstate 630, Exit 7, Little Rock, AR 72205-7202 | 2014-06-23 |
| 1659704351 | Sammantha Ann Hicks | Physical Therapist | 9601 Interstate 630, Exit 7, Little Rock, AR 72205-7202 | 2013-08-16 |
| 1114361425 | Chris Andrew Whaley | Rehabilitation Hospital | 9601 Interstate 630, Little Rock, AR 72205 | 2013-04-18 |
| 1366788796 | Chad Sullivan Stewart | Nurse Anesthetist, Certified Registered | 9601 Interstate 630, Exit 7, Little Rock, AR 72205-7202 | 2012-12-12 |
| 1225373657 | Emily Foster Eisenach | Nurse Anesthetist, Certified Registered | 9601 Interstate 630, Exit 7, Little Rock, AR 72205-7202 | 2012-12-12 |
| 1194061523 | Rebecca Wynne Novack | Nurse Anesthetist, Certified Registered | 9601 Interstate 630, Exit 7, Little Rock, AR 72205-7202 | 2012-12-12 |
| 1144462383 | Shayna Marie Wood | Pediatrics | 9601 Interstate 630, Little Rock, AR 72205-7202 | 2009-04-02 |
| 1316128499 | Kevin Charles Groustra | Physical Therapist | 9601 Interstate 630, Exit 7, Little Rock, AR 72205-7202 | 2007-11-17 |
| 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 | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| 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/certification - 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 |
|---|---|---|---|---|
| 1386937779 | Jennifer Ann Rumpel | Pediatrics | 1 Childrens Way # 512-5, Little Rock, AR 72202-3500 | 2011-05-18 |
| 1174729875 | Sara Ellen Peeples | Pediatrics | 1 Childrens Way # 512-05, Little Rock, AR 72202-3500 | 2007-06-21 |
| 1124410873 | Ankita Shukla | Pediatrics | 1 Childrens Way, Little Rock, AR 72202 | 2015-03-03 |
| 1417368887 | Ashley Lauren Lynch | Pediatrics | 1 Childrens Way # 512-1, Little Rock, AR 72202-3500 | 2014-05-19 |
| 1346667540 | Megha Sharma | Pediatrics | 1 Childrens Way # 512-5, Little Rock, AR 72202-3500 | 2014-03-25 |
| 1083956569 | Jonna Clark Marret | Pediatrics | 9601 Baptist Health Dr, Little Rock, AR 72205-6321 | 2013-03-21 |
| 1508132697 | David Neil Matlock Jr. | Pediatrics | 1 Childrens Way, Slot 512-19a, Little Rock, AR 72202-3500 | 2012-03-22 |
| 1871885525 | Jessica Farrell Jakubowicz | Pediatrics | 1 Childrens Way, Little Rock, AR 72202-3500 | 2011-05-12 |
| 1144462383 | Shayna Marie Wood | Pediatrics | 9601 Interstate 630, Little Rock, AR 72205-7202 | 2009-04-02 |
| 1417176744 | Samuel Burns | Pediatrics | 1 Childrens Way # 653, Little Rock, AR 72202-3500 | 2007-04-25 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72205 |
Please comment or provide details below to improve the information on PEDIATRIX MEDICAL GROUP OF ARKANSAS PA.
| 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.