MRS. MILDRED R WHITLEY (NPI# 1700042793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700042793 |
| Entity Type | Individual |
| Full Name | MRS. MILDRED R WHITLEY |
| Credential | PT |
| Practice Address |
11517 Kanis Rd Little Rock AR 72211-3724 |
| Mailing Address |
13817 Abinger Ct Little Rock AR 72212-3736 |
| Practice Telephone | 5019938707 |
| Practice Fax Number | 5012238075 |
| Mailing Telephone | 5012192202 |
| Mailing Fax Number | 5012238075 |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2008-07-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | PT 2087 | AR | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 168152721 | 05 |
| Street Address |
11517 KANIS RD |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72211-3724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275664708 | Amy Melissa Graves | Contractor | 11517 Kanis Rd, Little Rock, AR 72211-3724 | 2007-03-08 |
| 1760758585 | Kristen Givens King | Speech-Language Pathologist | 11517 Kanis Rd, Little Rock, AR 72211-3724 | 2012-03-26 |
| 1003190562 | Marcia Roles Bingham | Speech-Language Pathologist | 11517 Kanis Rd, Little Rock, AR 72211-3724 | 2011-10-03 |
| 1831409283 | Amanda Brook Johnson | Specialist | 11517 Kanis Rd, Little Rock, AR 72211-3724 | 2010-10-19 |
| 1649586363 | Connie Blasingame Bracy | Speech-Language Pathologist | 11517 Kanis Rd, Little Rock, AR 72211-3724 | 2010-08-19 |
| 1871735845 | Suzanne Roberson Mcclendon | Speech-Language Pathologist | 11517 Kanis Rd, Little Rock, AR 72211-3724 | 2009-04-06 |
| 1801040266 | Cameron Ray Carlisle | Speech-Language Pathologist | 11517 Kanis Rd, Little Rock, AR 72211-3724 | 2008-11-12 |
| 1285885426 | Mae Lynn Smithwick | Speech-Language Pathologist | 11517 Kanis Rd, Little Rock, AR 72211-3724 | 2008-10-07 |
| 1548426034 | Lyndal Green | Contractor | 11517 Kanis Rd, Little Rock, AR 72211-3724 | 2008-08-04 |
| 1619142361 | Greta A Hale | Speech-Language Pathologist | 11517 Kanis Rd, Little Rock, AR 72211-3724 | 2008-04-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760004618 | Samantha Lenore Hilborn | Behavior Technician | 1525 Merrill Drive Suite 100, Little Rock, AR 72211 | 2020-05-14 |
| 1003437740 | Centers for Youth and Families, Inc. | Community/Behavioral Health | 1521 Merrill Drive, Suite D220 and E200, Little Rock, AR 72211 | 2020-05-05 |
| 1962040568 | Erica N Taylor | Nurse Practitioner | 11800 Financial Center Parkway, Ste 290, Little Rock, AR 72211 | 2019-12-13 |
| 1568932119 | Katie Jones | Nurse Practitioner | 1children's Way, Little Rock, AR 72211 | 2018-11-27 |
| 1356828651 | Kayleigh King | Dietitian, Registered | 4 Shackleford Plz Ste 209, Little Rock, AR 72211 | 2018-07-19 |
| 1699283838 | Kara Elizabeth Simmons | Physician Assistant | 11215 Hermitage Rd Ste 103, Little Rock, AR 72211 | 2018-01-22 |
| 1194241463 | Wendy Newsam Pllc | Counselor | 1 Innwood Circle, Suite 107, Little Rock, AR 72211 | 2017-08-18 |
| 1861915159 | Sarah Renee Beall | Counselor | 10800 Financial Centre #290, Little Rock, AR 72211 | 2017-07-19 |
| 1457873127 | Restore Hope Counseling Center, Pllc | Counselor | One Innwood Circle, Suite 201, Little Rock, AR 72211 | 2017-07-13 |
| 1447707500 | University of Arkansas for Medical Sciences | Durable Medical Equipment & Medical Supplies | 601 Autumn Road, Little Rock, AR 72211 | 2016-09-07 |
| Find all providers in zip 72211 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568818672 | Jayvian Johnson | Contractor | 2116 E 11th St, Little Rock, AR 72202-4320 | 2016-05-06 |
| 1295196574 | Healthscope Benefits | Contractor | 27 Corporate Hill Dr, Little Rock, AR 72205-4537 | 2016-03-14 |
| 1639516545 | Harry Bassett | Contractor | 16 Marchwood Cv, Little Rock, AR 72210-3704 | 2013-05-31 |
| 1629340047 | Georgia Abner | Contractor | 6007 Mandan Rd, Little Rock, AR 72210-3046 | 2012-01-31 |
| 1356509327 | Marilyn Jamie Eubanks | Contractor | 1301 Biscayne Dr, Little Rock, AR 72227-5816 | 2008-05-27 |
| 1780857128 | Alicia Anne Watson | Contractor | 2923 Circlewood Dr, Little Rock, AR 72207-2609 | 2008-04-07 |
| 1689883209 | Superior Source Inc | Contractor | 78 Westminister Dr, Little Rock, AR 72209-2949 | 2007-05-21 |
| 1275664708 | Amy Melissa Graves | Contractor | 11517 Kanis Rd, Little Rock, AR 72211-3724 | 2007-03-08 |
| 1356470025 | Jeanne Miller | Contractor | 14701 Cecil Dr, Little Rock, AR 72223-1913 | 2007-03-05 |
| 1730221797 | Caroline Le | Contractor | 12720 Pleasant View Dr, Little Rock, AR 72212-2227 | 2007-02-13 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72211 |
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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.