NPIMap

Individual provider Active NPI

Ethan J Schock, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Little Rock, AR
National Provider Identifier
1033197215
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
E-2961 Issued in AR
Practice address
800 Fair Park Blvd
Little Rock, AR 72204
Phone
(501) 663-3647
Fax
(501) 666-9653
NPI assigned
Jan 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X E-2961 AR Primary

Addresses

Primary practice location

800 Fair Park Blvd
Little Rock, AR 72204

Mailing address

800 Fair Park Blvd
Little Rock, AR 72204-1720
Phone (501) 404-8007

Other identifiers 2

IdentifierTypeStateIssuer
145157001MedicaidAR
5L876C207OtherARMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040126000460 AR Practitioner - Orthopedic Surgery 6305748617 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Arkansas College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fands Physical Therapy, IncGroup PAC ID 7810898459, 217 clinicians
Orthoarkansas PAGroup PAC ID 1456256031, 148 clinicians

Practice addresses (Care Compare)

1414 Hwy 71 N
Alma, AR 72921-4723
Phone (479) 632-0321

800 Fair Park Blvd
Little Rock, AR 72204-1720
Phone (501) 500-3500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement23
Lower limb (leg) arthroscopy (minimally invasive joint repair)36
Upper limb (arm) arthroscopy (minimally invasive joint repair)107
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoarkansas, PA CurrentSince Dec 1, 2003 Accepting new patients
Orthoarkansas, PA CurrentSince Dec 1, 2003 Accepting new patients
Orthoarkansas, PA PastSince Aug 1, 2005 Accepting new patients
South Arkansas Orthopaedics and Sports Medicine Center PLLC Sports Medicine Past Accepting new patients
St. Vincent-Arkansas Orthopaedic Surgery Center LLC Past Accepting new patients

Locations

353 Cash Rd SW
Camden, AR 71701
Phone (870) 836-8101

6119 Midtown Ave
Ste 101
Little Rock, AR 72205
Phone (501) 404-8007

800 Fair Park Blvd
Little Rock, AR 72204
Phone (501) 404-8007

3480 Landers Rd
North Little Rock, AR 72117
Phone (501) 955-5519

1525 Country Club Rd
Sherwood, AR 72120
Phone (501) 758-1530

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1376/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/1376/brand/1/csg/21/fhir/r4
  • Direct secure messaging: ethan.schock.1@1376.direct.athenahealth.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1033197215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FAIR PARK BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041720",
            "telephone_number": "501-404-8007",
            "fax_number": "501-904-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FAIR PARK BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72204",
            "telephone_number": "501-663-3647",
            "fax_number": "501-666-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOCK",
        "first_name": "ETHAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AR",
            "license": "E-2961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145157001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "5L876C207",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.