ST. VINCENT MEDICAL GROUP NPI 1134176480

NPI Information

NPI: 1134176480
Provider Name: ST. VINCENT MEDICAL GROUP
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 04D0952060

Address:
2 ST. VINCENT CIRCLE
LITTLE ROCK, AR
ZIP 72205
Phone: (501) 552-3571
Get Directions

ST. VINCENT MEDICAL GROUP is a family medicine in Little Rock, AR. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ST. VINCENT MEDICAL GROUP NPI is 1134176480. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2 ST. VINCENT CIRCLE
LITTLE ROCK, AR
ZIP 72205-936
Phone: (501) 552-3571
Fax: (501) 552-4129

The provider's authorized official is Jamie Dennis .
The authorized official title is Director and has the following contact phone number (501) 224-1690.

The CLIA number assigned to this NPI record is 04D0952060 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/30/2006 and was last updated on 2/10/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207R00000X	Internal Medicine		No
2	207T00000X	Neurological Surgery		No
3	208000000X	Pediatrics		No
4	2080P0207X	Pediatrics	Pediatric Hematology-Oncology	No
5	208100000X	Physical Medicine & Rehabilitation		No
6	2084N0400X	Psychiatry & Neurology	Neurology	No
7	2084P0800X	Psychiatry & Neurology	Psychiatry	No
8	208600000X	Surgery		No
9	213EP1101X	Podiatrist	Primary Podiatric Medicine	No
10	363L00000X	Nurse Practitioner		No
11	207RG0100X	Internal Medicine	Gastroenterology	No
12	207RH0003X	Internal Medicine	Hematology & Oncology	No
13	207RP1001X	Internal Medicine	Pulmonary Disease	No
14	207Q00000X	Family Medicine		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	138898002	MEDICAID	ARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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