Individual provider Active NPI

Clay Andrew Simon, MSN-FNP

  • Family Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1083336382
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
221426 Issued in AR
Practice address
6805 Cantrell Rd
Little Rock, AR 72207-4134
Phone
(501) 260-7992
NPI assigned
Sep 13, 2022
Last updated
Sep 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 221426 AR Primary

Addresses

Primary practice location

6805 Cantrell Rd
Little Rock, AR 72207-4134

Mailing address

21925 Mountain Maple Cir
Hensley, AR 72065-9022
Phone (501) 590-3104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221011003013 AR Practitioner - Nurse Practitioner 6204202534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Greenbrier Emergency Services, Inc.Group PAC ID 2668377359, 53 clinicians
Christopher K Mocek MD PAGroup PAC ID 8224314216, 5 clinicians

Practice addresses (Care Compare)

3333 Springhill Dr
North Little Rock, AR 72117-2922
Phone (501) 202-3000

9101 Kanis Rd
Suite 400
Little Rock, AR 72205-6450
Phone (501) 224-4001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
78.7
Improvement activities
40
Cost
74.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher K Mocek MD PA CurrentSince Feb 26, 2024 Accepting new patients
Greenbrier Emergency Services, Inc. CurrentSince Mar 9, 2023 Accepting new patients

Locations

9101 Kanis Rd
Ste 400
Little Rock, AR 72205
Phone (501) 978-8618

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

3333 Springhill Dr
North Little Rock, AR 72117
Phone (501) 202-3000

Organizations & group practices 2

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

Hospital & facility affiliations 2

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": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1083336382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21925 MOUNTAIN MAPLE CIR",
            "city": "HENSLEY",
            "state": "AR",
            "postal_code": "720659022",
            "telephone_number": "501-590-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6805 CANTRELL RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722074134",
            "telephone_number": "501-260-7992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "CLAY",
        "middle_name": "ANDREW",
        "credential": "MSN-FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-13",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "221426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.