AUTUMN ROAD FAMILY PRACTICE, P.A,
NPI 1629027818
Clinic/Center in Little Rock, AR

Active since May 08, 2006CLIA 04D0467303 · Certificate of Compliance
904 AUTUMN RD, SUITE 200, LITTLE ROCK, AR 72211(501) 227-6363(501) 227-8629 Get Directions Write a Review

NPPES record last updated: May 31, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Autumn Road Family Practice, P.a, NPPES

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

AUTUMN ROAD FAMILY PRACTICE, P.A, (NPI 1629027818) is a healthcare organization registered as a clinic/center in Little Rock, Arkansas and active in the NPI registry since May 2006. The organization holds a CLIA Certificate of Compliance certificate valid through February 13, 2027 and lists Dawn Drennan, Administrator, as its authorized official.

NPPES Registry Identity

NPI1629027818
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameAUTUMN ROAD FAMILY PRACTICE, P.A,
Location Address904 AUTUMN RD, SUITE 200Little Rock, AR 72211-3737
Mailing Address904 Autumn Rd, Suite 200Little Rock, AR 72211-3737 · (501) 227-6363 · Fax (501) 227-8629
Fax(501) 227-8629
Organization SubpartNo
Authorized OfficialDawn DrennanAdministrator · (501) 626-7515
Enumeration DateMay 8, 2006
Last NPPES UpdateMay 31, 2022
NPPES CertifiedMay 31, 2022
NPI 1629027818 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License Licensed in AR · MC0079
Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

904 AUTUMN RD, Little Rock, AR 72211

Other Identifiers 1

Medicaid111026102AR

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 04D0467303

Autumn Road Family Practice, PA · Little Rock, AR
Active · expires Feb 13, 2027
CLIA Number04D0467303
Laboratory TypePhysician Office
Certificate Effective DateFebruary 14, 2025
Certificate Expiration DateFebruary 13, 2027
Laboratory DirectorSarah Mikula
Laboratory Phone(501) 227-6363
Laboratory LocationAutumn Road Family Practice, PA904 Autumn Road, Suite 200, Little Rock, AR 72211
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 13

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

Family Medicine
904 AUTUMN RD, SUITE 200
LITTLE ROCK, AR 72211
Pharmacy
904 AUTUMN RD, SUITE 275
LITTLE ROCK, AR 72211
Pediatrics
904 AUTUMN RD, SUITE 100
LITTLE ROCK, AR 72211
Preferred Provider Organization
904 AUTUMN RD, SUITE 100
LITTLE ROCK, AR 72211
Pediatrics
904 AUTUMN RD, SUITE 100
LITTLE ROCK, AR 72211
Family Medicine
904 AUTUMN RD, SUITE 200
LITTLE ROCK, AR 72211
Family Medicine
904 AUTUMN RD, SUITE 200
LITTLE ROCK, AR 72211
Pediatrics
904 AUTUMN RD, SUITE 100
LITTLE ROCK, AR 72211

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 Autumn Road Family Practice, P.A,'s NPI number?

The NPI number for Autumn Road Family Practice, P.A, is 1629027818. It was assigned to this organization in the NPPES registry on May 8, 2006.

Where is Autumn Road Family Practice, P.A, located?

Autumn Road Family Practice, P.A, is located at 904 Autumn Rd Suite 200, Little Rock, AR 72211. The listed phone number is (501) 227-6363.

What is Autumn Road Family Practice, P.A,'s specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Autumn Road Family Practice, P.A, hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 04D0467303) is associated with this NPI, valid through February 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Autumn Road Family Practice, P.A, accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 other insurers list Autumn Road Family Practice, P.A, as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Autumn Road Family Practice, P.A, was last updated on May 31, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.