Individual provider Active NPI

Stephanie Cody, M.D.

  • Family Medicine Physician
  • Little Rock, AR
National Provider Identifier
1275632903
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-2687 Issued in AR
Practice address
2601 Kavanaugh Blvd Ste 6
Little Rock, AR 72205-3991
Phone
(501) 663-4357
Fax
(501) 663-3357
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-2687 AR Primary

Addresses

Primary practice location

2601 Kavanaugh Blvd Ste 6
Little Rock, AR 72205-3991

Mailing address

11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (501) 812-7800

Other identifiers 1

IdentifierTypeStateIssuer
141533001MedicaidAR

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
I20051011001104 AR Practitioner - Family PracticePractitioner - Emergency Medicine 4486679131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, shared by 52 NPIs, 645 clinicians

Practice addresses (Care Compare)

2601 Kavanaugh Blvd
Suite 6
Little Rock, AR 72205-3991
Phone (501) 663-4357

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-2687ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group Family Medicine CurrentSince Aug 1, 2017 Accepting new patients
Arkansas Health Group CurrentSince Sep 1, 2020 Accepting new patients
Arkansas Health Group Family Medicine Past Accepting new patients

Locations

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

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

9601 Interstate 630
Little Rock, AR 72205
Phone (501) 202-2300

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

2601 Kavanaugh Blvd
Ste 6
Little Rock, AR 72205
Phone (501) 614-8072

1001 Schneider Dr
Malvern, AR 72104
Phone (501) 332-1000

778 Scogin Dr
Monticello, AR 71655
Phone (870) 367-2411

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

Interoperability endpoints

  • Direct secure messaging: scody3042@direct.baptist-healthar.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1275632903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "501-812-7800",
            "fax_number": "501-812-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 KAVANAUGH BLVD STE 6",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053991",
            "telephone_number": "501-663-4357",
            "fax_number": "501-663-3357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CODY",
        "first_name": "STEPHANIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-2687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141533001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.