Active NPI
Blake Sherwood
- Physical Therapist
- Little Rock, AR
National Provider Identifier
1245907807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5051
- Practice address
- 5307 Kavanaugh Blvd
Little Rock, AR 72207-4610 - Phone
- (501) 301-4530
- NPI assigned
- Aug 23, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5051 | AR | Primary |
Addresses
Primary practice location
5307 Kavanaugh Blvd
Little Rock, AR 72207-4610
Mailing address
1909 Hinson Loop Rd Ste 100
Little Rock, AR 72212-3903
Phone (501) 301-4530
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5051 | AR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629676800000",
"number": "1245907807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1909 HINSON LOOP RD STE 100",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722123903",
"telephone_number": "501-301-4530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5307 KAVANAUGH BLVD",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722074610",
"telephone_number": "501-301-4530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERWOOD",
"first_name": "BLAKE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-23",
"last_updated": "2021-08-23",
"certification_date": "2021-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "5051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.