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SHAYLA RUTH MCKISSOCK
NPI 1730918780
Student in an Organized Health Care Education/Training Program in Little Rock, AR

Active since July 29, 2024PECOS Enrolled
4301 W MARKHAM ST, LITTLE ROCK, AR 72205(501) 868-8000 Get Directions Write a Review

NPPES record last updated: December 18, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 18, 2024, Jul 29, 2024 (2 updates tracked since 2024).

About Shayla Ruth Mckissock NPPES

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

SHAYLA RUTH MCKISSOCK (NPI 1730918780) is an individual student in an organized health care education/training program in Little Rock, Arkansas and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1730918780
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameSHAYLA RUTH MCKISSOCK
Location Address4301 W MARKHAM STLittle Rock, AR 72205-7199
Mailing Address4301 W Markham StLittle Rock, AR 72205-7101 · (501) 686-8000
Phone(501) 868-8000
Sole ProprietorNo
Enumeration DateJuly 29, 2024
Last NPPES UpdateDecember 18, 20242 updates tracked since enumeration
NPPES CertifiedDecember 18, 2024
✔ NPI 1730918780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
4301 W MARKHAM ST, Little Rock, AR 72205
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shayla Ruth Mckissock is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

MRS. LESLEY BROOKE JONES R.D.
Dietitian, Registered
4301 W MARKHAM ST
LITTLE ROCK, AR 72205
Pulaski County (501) 686-6857
NANCY MAALOUF M.D.
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST, SLOT # 500
LITTLE ROCK, AR 72205
Pulaski County (501) 296-1165
DR. ARMANDO LEONEL MARTINEZ M.D.
Emergency Medicine
4301 W MARKHAM ST, SLOT 783
LITTLE ROCK, AR 72205
Pulaski County (501) 686-8000
ELENA AMBROGINI MD PHD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
4301 W MARKHAM ST, # 783
LITTLE ROCK, AR 72205
Pulaski County (501) 686-8000
SUKANTHI KOVVURU
Psychiatry & Neurology (Neuromuscular Medicine)
4301 W MARKHAM ST
LITTLE ROCK, AR 72205
Pulaski County (609) 865-3702
JORDAN ALEECE FLETCHER
Obstetrics & Gynecology
4301 W MARKHAM ST
LITTLE ROCK, AR 72205
Pulaski County (501) 686-7000
DR. TYLER KRISTOPHER ROSE M.D.
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST
LITTLE ROCK, AR 72205
Pulaski County (501) 686-8000
LUKE WILLIAM GANUCHEAU MD
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST
LITTLE ROCK, AR 72205
Pulaski County (501) 376-2211

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 Shayla Mckissock's NPI number?

The NPI number for Shayla Mckissock is 1730918780. It was assigned to this individual provider in the NPPES registry on July 29, 2024.

Where is Shayla Mckissock located?

Shayla Mckissock practices at 4301 W Markham St, Little Rock, AR 72205. The listed phone number is (501) 868-8000.

What is Shayla Mckissock's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Shayla Mckissock enrolled in Medicare?

Yes. Shayla Mckissock is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shayla Mckissock was last updated on December 18, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.