Individual provider Active NPI

Blakely Reeder, NP

  • Nurse Practitioner
  • N Little Rock, AR
National Provider Identifier
1205345386
Registry record updated Sep 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A005358 Issued in AR
Practice address
5201 Northshore Dr
N Little Rock, AR 72118-5312
Phone
(877) 918-7020
Fax
(479) 968-1673
NPI assigned
Sep 21, 2017
Last updated
Sep 21, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A005358 AR Primary

Addresses

Primary practice location

5201 Northshore Dr
N Little Rock, AR 72118-5312

Mailing address

PO Box 9178
Russellville, AR 72811-9178
Phone (866) 601-8435

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
I20171011000700 AR Practitioner - Nurse Practitioner 2466727821 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient SolutionsGroup PAC ID 5597195206, 31 clinicians
General Emergency Physicians IncGroup PAC ID 7618148800, 14 clinicians

Practice addresses (Care Compare)

5 Medical Park Dr
Suite 304
Benton, AR 72015-3745
Phone (501) 408-2429

5201 Northshore Dr
North Little Rock, AR 72118-5312
Phone (877) 918-7020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
18.84 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
62.79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A005358ARMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Surgical Hospital, LLC CurrentSince Jul 20, 2020 Accepting new patients
General Emergency Physicians, Inc. CurrentSince Sep 15, 2017 Accepting new patients
Arkansas Surgical Hospital, LLC CurrentSince Jul 20, 2020 Accepting new patients
Arkansas Surgical Hospital, LLC Current Accepting new patients

Locations

1201 Military Rd
Ste 2
Benton, AR 72015

5201 Northshore Dr
North Little Rock, AR 72118
Phone (501) 748-8000

5201 Northshore Dr
Ste 300
North Little Rock, AR 72118
Phone (501) 748-8000

Organizations & group practices 5

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 1

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": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505952000000",
    "number": "1205345386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9178",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728119178",
            "telephone_number": "866-601-8435",
            "fax_number": "479-968-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 NORTHSHORE DR",
            "city": "N LITTLE ROCK",
            "state": "AR",
            "postal_code": "721185312",
            "telephone_number": "877-918-7020",
            "fax_number": "479-968-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDER",
        "first_name": "BLAKELY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-21",
        "last_updated": "2017-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A005358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in N Little Rock, AR

Sources for this page

Verify at the official NPI Registry.