NPIMap

Organization Active NPI

Bedrock Psychiatry

  • Psychiatry Physician
  • Little Rock, AR
National Provider Identifier
1013723048
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
BEDROCK PSYCHIATRY
Practice address
1405 N Pierce St Ste 212
Little Rock, AR 72207-5357
Phone
(501) 725-0205
Fax
(254) 212-4442
NPI assigned
Dec 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kelsey McClellan, MDNPI 1457679011
Title
Owner
Phone
(501) 725-0205

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1405 N Pierce St Ste 212
Little Rock, AR 72207-5357

Mailing address

PO Box 241248
Little Rock, AR 72223-0005
Phone (501) 725-0205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250820001769 AR Part B Supplier - Clinic/Group Practice 7315446861 Receives reassigned benefits from 8 practitioners
Practice locations: Benton, AR; Little Rock, AR; Maumelle, AR; Rogers, AR

National Provider Directory

National Provider Directory

Locations

6213 Father Tribou St
Ste 2A
Little Rock, AR 72205

415 N McKinley St
Ste 550
Little Rock, AR 72205
Phone (501) 635-9900

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1013723048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241248",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722230005",
            "telephone_number": "501-725-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 N PIERCE ST STE 212",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722075357",
            "telephone_number": "501-725-0205",
            "fax_number": "254-212-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEDROCK PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "MCCLELLAN",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-725-0205",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.