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OTTER CREEK FAMILY CLINIC PLLC
NPI 1336122340
Internal Medicine in Little Rock, AR

Active since November 23, 2005
11321 INTERSTATE 30, STE 101, LITTLE ROCK, AR 72209(501) 455-1331(501) 455-5597 Get Directions Write a Review

NPPES record last updated: June 23, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Otter Creek Family Clinic Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OTTER CREEK FAMILY CLINIC PLLC (NPI 1336122340) is a healthcare organization registered as an internal medicine in Little Rock, Arkansas and active in the NPI registry since November 2005. The organization lists Rita A Alexander, Billing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1336122340
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameOTTER CREEK FAMILY CLINIC PLLC
Location Address11321 INTERSTATE 30, STE 101Little Rock, AR 72209-7059
Mailing Address11321 Interstate 30, Ste 101Little Rock, AR 72209-7059 · (501) 455-1331 · Fax (501) 455-5597
Phone(501) 455-1331
Fax(501) 455-5597
Organization SubpartNo
Authorized OfficialRita A AlexanderBilling Coordinator · (501) 455-1331
Enumeration DateNovember 23, 2005
Last NPPES UpdateJune 23, 2010
✔ NPI 1336122340 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in AR · C5502
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
11321 INTERSTATE 30, Little Rock, AR 72209
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Other Identifiers 4

Medicare UPIND09035
Medicare PIN5B653
OtherCG8625Rr Medicare
Medicaid140671002AR

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. STEPHEN SNYDER MD
Internal Medicine
11321 INTERSTATE 30, SUITE 101
LITTLE ROCK, AR 72209
Pulaski County (501) 455-1331
TONYA LEIGH SCRIMSHIRE MHPP
Case Manager/Care Coordinator
11321 INTERSTATE 30, SUITE 104
LITTLE ROCK, AR 72209
Pulaski County (501) 202-7587
JEREMY DAVIS MHPP
Case Manager/Care Coordinator
11321 INTERSTATE 30, SUITE 104
LITTLE ROCK, AR 72209
Pulaski County (501) 315-3344
KONDO ENTERPRISES CORP
Pharmacist
11321 INTERSTATE 30, SUITE 102
LITTLE ROCK, AR 72209
Pulaski County (501) 353-2136
ELIZABETH WINNINGHAM APRN
Nurse Practitioner (Family)
11321 INTERSTATE 30, SUITE 101
LITTLE ROCK, AR 72209
Pulaski County (501) 455-1331
REBECCA MCCUTCHEON MHPP
Case Manager/Care Coordinator
11321 INTERSTATE 30, SUITE 104
LITTLE ROCK, AR 72209
Pulaski County (501) 202-7587
MR. JAY CHARLES STAKE MHPP
Case Manager/Care Coordinator
11321 INTERSTATE 30
LITTLE ROCK, AR 72209
Pulaski County (501) 202-7587
DR. CHARLES RICHARD CHAMBLEE JR. D.MIN; M.DIV; L.A.C.
Counselor (Professional)
11321 INTERSTATE 30, SUITE 304
LITTLE ROCK, AR 72209
Pulaski County (501) 202-7587

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Otter Creek Family Clinic PLLC's NPI number?

The NPI number for Otter Creek Family Clinic PLLC is 1336122340. It was assigned to this organization in the NPPES registry on November 23, 2005.

Where is Otter Creek Family Clinic PLLC located?

Otter Creek Family Clinic PLLC is located at 11321 Interstate 30 Ste 101, Little Rock, AR 72209. The listed phone number is (501) 455-1331.

What is Otter Creek Family Clinic PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Otter Creek Family Clinic PLLC was last updated on June 23, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.