Individual provider Active NPI

Gerald Bradley Schaefer, MD

  • Clinical Genetics (M.D.) Physician
  • Springdale, AR
National Provider Identifier
1225089204
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
E5822 Issued in AR
Practice address
2601 Gene George Blvd
Springdale, AR 72762-0845
Phone
(479) 725-6880
Fax
(479) 725-6582
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X 18185 NE
Pediatric Endocrinology Physician 2080P0205X E5822 AR
Pediatric Endocrinology Physician 2080P0205X 18185 NE
Clinical Genetics (M.D.) Physician 207SG0201X E5822 AR Primary

Addresses

Primary practice location

2601 Gene George Blvd
Springdale, AR 72762-0845

Mailing address

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

Other identifiers 1

IdentifierTypeStateIssuer
126153001MedicaidAR

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081020000574 AR Practitioner - Endocrinology 1658439658 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E5822ARMDClinical Genetics (M.D.) Physician
18185NEMDClinical Genetics (M.D.) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Children'S Hospital CurrentSince Aug 11, 2008 Accepting new patients
Arkansas Childrens Hospital CurrentSince Aug 11, 2008 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Apr 30, 2014 Accepting new patients
Wesley Pathology Consultants PA Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Apr 30, 2014 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Apr 30, 2014 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2014 Accepting new patients

Locations

1125 N College Ave
Fayetteville, AR 72703
Phone (479) 521-8260

800 Marshall St
#653
Little Rock, AR 72202
Phone (501) 354-1100

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

2601 Gene George Blvd
Springdale, AR 72762
Phone (479) 725-6800

550 N Hillside St
Fl 5
Wichita, KS 67214
Phone (316) 962-2156

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1225089204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 GENE GEORGE BLVD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620845",
            "telephone_number": "479-725-6880",
            "fax_number": "479-725-6582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "GERALD",
        "middle_name": "BRADLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "NE",
            "license": "18185",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "AR",
            "license": "E5822",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NE",
            "license": "18185",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "AR",
            "license": "E5822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126153001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

Verify at the official NPI Registry.