EVERGREEN INTERNAL MEDICINE PLLC (NPI# 1801017595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1801017595 |
Entity Type | Organization |
Organization Name | EVERGREEN INTERNAL MEDICINE PLLC |
Practice Address |
1100 N University Ave Suite 125 Little Rock AR 72207-6343 |
Practice Telephone | 5016641540 |
Mailing Telephone | 5016641540 |
Enumeration Date | 2007-05-01 |
Last Update Date | 2009-10-21 |
Authorized Official Name | DR. ROBERT A HENRY (MANAGING MEMBER) |
Authorized Official Telephone | 5016641540 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
Street Address |
1100 N UNIVERSITY AVE SUITE 125 |
City | LITTLE ROCK |
State | AR |
Zip Code | 72207-6343 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427048677 | Sherri G. Parks | Clinical Nurse Specialist | 1100 N University Ave, Suite 200, Little Rock, AR 72207-6343 | 2005-10-27 |
1043841091 | Gary Appleby Blonsky | Social Worker | 1100 N University Ave, Little Rock, AR 72207-6343 | 2020-01-29 |
1780121269 | Lrcmhc | Community/Behavioral Health | 1100 N University Ave, Little Rock, AR 72207-6343 | 2017-01-23 |
1730634825 | Ashton Robbins | Case Manager/Care Coordinator | 1100 N University Ave, Evergreen Place Suite 200, Little Rock, AR 72207-6343 | 2016-08-18 |
1396195723 | Margaret Hicks | Social Worker | 1100 N University Ave, Suite 200, Little Rock, AR 72207-6343 | 2016-06-16 |
1295183432 | Kirby Danielle Caddy | Social Worker | 1100 N University Ave, Suite 200, Little Rock, AR 72207-6343 | 2016-05-27 |
1548629751 | Stefany Knight | Social Worker | 1100 N University Ave, Suite 200, Little Rock, AR 72207-6343 | 2016-02-16 |
1790143014 | Michael Mclaughlin | Registered Nurse | 1100 N University Ave, Suite 200, Little Rock, AR 72207-6343 | 2016-02-01 |
1104213842 | Toynicka Nicole Williams | Registered Nurse | 1100 N University Ave, 200, Little Rock, AR 72207-6343 | 2015-04-21 |
1104258714 | Karon Patrice Cunningham | Case Manager/Care Coordinator | 1100 N University Ave, 200, Little Rock, AR 72207-6343 | 2013-08-06 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245754555 | Yolanda Johnson | Case Manager/Care Coordinator | 1100 N University Suite 200, Little Rock, AR 72207 | 2017-07-28 |
1275065146 | Mccallum Medical Pa | Emergency Medicine | 1923 N Tyler St, Little Rock, AR 72207 | 2017-03-30 |
1700326790 | Denira Zardoost | Case Manager/Care Coordinator | 1100 N.uiversity, Evergreen Place Suite 200, Little Rock, AR 72207 | 2017-02-24 |
1952794828 | Robert Young Md | Clinic/Center | 4617 Crestwood Dr, Little Rock, AR 72207 | 2015-03-16 |
1366711004 | Amanda Diane Berg | Massage Therapist | 1405 N. Pierce St., Suite 210, Little Rock, AR 72207 | 2011-12-27 |
1801184080 | Larra Jean Bender | Massage Therapist | 1405 N. Pierce St. Suite 210, Little Rock, AR 72207 | 2011-07-21 |
1326371550 | Elizabeth G White | Social Worker | 1501 N University Ave Ste 416, Little Rock, AR 72207 | 2009-09-04 |
1437334364 | Lori Lamitina Nicholson | Chiropractor | 1405 North Pierce Street, Suite 210, Little Rock, AR 72207 | 2008-01-09 |
1568656858 | Megan Elizabeth Hughes | Social Worker | 5905 Forest Place, Little Rock, AR 72207 | 2007-08-30 |
1336361955 | Jennifer Baldwin | Occupational Therapist | 7204 M St, Little Rock, AR 72207 | 2007-05-03 |
Find all providers in zip 72207 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568942977 | Premise Health of Arkansas Medical P A | Clinic/Center | 11215 Hermitage Rd Ste 205, Little Rock, AR 72211-3864 | 2018-08-15 |
1912430018 | Allegiant Wellness and Testosterone Replacement, Inc. | Clinic/Center | 11121 N Rodney Parham Rd Ste 2a, Little Rock, AR 72212-4158 | 2017-04-05 |
1912221268 | Imwell Health | Clinic/Center | 401 W Capitol Ave Ste 345, Little Rock, AR 72201-3475 | 2010-03-16 |
1245416007 | Medbasics Arkansas LLC | Clinic/Center | 105 N Rodney Parham Rd, Little Rock, AR 72205-2421 | 2008-01-10 |
1770997231 | Baptist Health Onsite Employee Clinic | Clinic/Center | 11001 Executive Center Dr, Ste 200, Little Rock, AR 72211-4316 | 2014-06-12 |
1215282231 | Bethesda Health and Wellness Clinic | Clinic/Center | 500 S University Ave, Suite 515, Little Rock, AR 72205-5302 | 2012-07-16 |
1841593555 | Shawn Cones, M.d., Pllc, Pa | Clinic/Center | 3401 Atwood Rd, Suite B, Little Rock, AR 72206-6012 | 2010-12-20 |
1427379387 | Full Potential | Clinic/Center | 8109 Interstate 30, Little Rock, AR 72209-4840 | 2010-06-15 |
1609058643 | Carter Family Medicine Clinic, Pllc | Clinic/Center | 500 S University Ave, Suite 521, Little Rock, AR 72205-5302 | 2007-12-01 |
1851436117 | Pinnacle Family Medicine, P.a. | Clinic/Center | 11321 Interstate 30, Suite 202, Little Rock, AR 72209-7040 | 2007-02-21 |
Find all providers in LITTLE ROCK |
City | LITTLE ROCK |
Zip Code | 72207 |
Please comment or provide details below to improve the information on EVERGREEN INTERNAL MEDICINE PLLC.
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.