# ST. VINCENT MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134176480
- **Authorized official:** JAMIE DENNIS (DIRECTOR)
- **Authorized official phone:** (501) 224-1690

## Contact information

- **Practice address:** 2 ST. VINCENT CIRCLE, LITTLE ROCK, AR 72205-2936
- **Practice address phone:** (501) 552-3571
- **Practice address fax:** (501) 224-1927
- **Mailing address:** 5125 NORTHSHORE DR, NORTH LITTLE ROCK, AR 72118-5315
- **Mailing address phone:** (501) 224-1690
- **Mailing address fax:** (501) 224-1927

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RG0100X | Gastroenterology Physician | — | NULL | — |
| 207RG0100X | Gastroenterology Physician | — | — | — |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | — |
| 207RH0003X | Hematology & Oncology Physician | — | — | — |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 207T00000X | Neurological Surgery Physician | — | NULL | — |
| 207T00000X | Neurological Surgery Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2080P0207X | Pediatric Hematology & Oncology Physician | — | NULL | — |
| 2080P0207X | Pediatric Hematology & Oncology Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 213EP1101X | Primary Podiatric Medicine Podiatrist | — | NULL | — |
| 213EP1101X | Primary Podiatric Medicine Podiatrist | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 05/30/2006
- **Last updated:** 04/24/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 138898002 | — | AR |