DR. JENNINGS R BOYETTE (NPI# 1922216084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922216084 |
| Entity Type | Individual |
| Full Name | DR. JENNINGS R BOYETTE |
| Credential | MD |
| Practice Address |
4301 W Markham St Dept. of Otolaryngology, #543 Little Rock AR 72205-7101 |
| Mailing Address |
521 N Pine St Little Rock AR 72205-3937 |
| Practice Telephone | 5016031214 |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2013-07-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
MD.205264 | LA | Allopathic & Osteopathic Physicians |
| Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
E-7894 | AR | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | AR | Student, Health Care |
| Street Address |
4301 W MARKHAM ST DEPT. OF OTOLARYNGOLOGY, #543 |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72205-7101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811998487 | Jan K Hastings | Pharmacist | 4301 W Markham St, #522, Little Rock, AR 72205-7101 | 2005-08-04 |
| 1043810971 | Prashanth Reddy Damalcheruvu | Student in an Organized Health Care Education/Training Program | 4301 W Markham St, Little Rock, AR 72205-7199 | 2020-10-29 |
| 1114533619 | Nitesh Gautam | Student in an Organized Health Care Education/Training Program | 4301 W Markham St, Little Rock, AR 72205-7101 | 2020-09-20 |
| 1891301818 | Rachel Rosenbaum | Nurse Practitioner | 4301 W Markham St, Little Rock, AR 72205-7101 | 2020-09-16 |
| 1477164861 | Ashtyn Leann Knowles | Dietitian, Registered | 4301 W Markham St, Little Rock, AR 72205-7101 | 2020-08-11 |
| 1700404118 | Candace Johnson | Social Worker | 4301 W Markham St, Little Rock, AR 72205-7101 | 2020-07-12 |
| 1851919245 | Omar Alqaisi | Student in an Organized Health Care Education/Training Program | 4301 W Markham St, Little Rock, AR 72205-7101 | 2020-07-11 |
| 1295364578 | Julie Michelle Nessler | Student in an Organized Health Care Education/Training Program | 4301 W Markham St, Little Rock, AR 72205-7101 | 2020-04-07 |
| 1346879079 | Brian Wesley Rhea | Student in an Organized Health Care Education/Training Program | 4301 W Markham St, Little Rock, AR 72205-7199 | 2020-04-04 |
| 1265060388 | Erin Elizabeth Hall | Student in an Organized Health Care Education/Training Program | 4301 W Markham St, Slot 517, Little Rock, AR 72205-7101 | 2020-04-01 |
| 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 | 207YX0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Plastic Surgery within the Head & Neck |
| An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245466861 | Mauricio Alejandro Moreno Vera | Otolaryngology | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2009-06-10 |
| 1265522759 | James Suen | Otolaryngology | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2006-10-13 |
| 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.