Individual provider Active NPI

Steven Anthony Flynn, B.O.C.O., C.F.O.

  • Orthotist
  • North Little Rock, AR
National Provider Identifier
1053564682
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OrthotistTaxonomy code 222Z00000X
Practice address
2200 Fort Roots Dr
BLDG. 89, Rm101
North Little Rock, AR 72114-1709
Phone
(501) 257-1610
Fax
(501) 257-1624
NPI assigned
Oct 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotist 222Z00000X Primary

Addresses

Primary practice location

2200 Fort Roots Dr
BLDG. 89, Rm101
North Little Rock, AR 72114-1709

Mailing address

21616 N Mill Rd
Little Rock, AR 72206-9457
Phone (501) 257-1610

Other identifiers 2

IdentifierTypeStateIssuer
BOC36416OtherBOARD OF CERTIFICATION
CF00389OtherAMERICAN BOARD FOR CERTIFICATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1053564682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21616 N MILL RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722069457",
            "telephone_number": "501-257-1610",
            "fax_number": "501-257-1624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 FORT ROOTS DR",
            "address_2": "BLDG. 89, RM101",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721141709",
            "telephone_number": "501-257-1610",
            "fax_number": "501-257-1624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "STEVEN",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "B.O.C.O., C.F.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF CERTIFICATION",
            "identifier": "BOC36416",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN BOARD FOR CERTIFICATION",
            "identifier": "CF00389",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.