Individual provider Active NPI

Carl Stevens, MD

  • Anesthesiology Physician
  • Little Rock, AR
National Provider Identifier
1477537306
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
E0618 Issued in AR
Practice address
6119 Midtown Ave
Suite 201
Little Rock, AR 72205-5313
Phone
(501) 664-4532
Fax
(501) 663-4335
NPI assigned
Dec 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X E0618 AR Primary

Addresses

Primary practice location

6119 Midtown Ave
Suite 201
Little Rock, AR 72205-5313

Mailing address

6119 Midtown Ave
Suite 201
Little Rock, AR 72205-5313
Phone (501) 664-4532

Other identifiers 2

IdentifierTypeStateIssuer
100079270AMedicaidOK
131833001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20170124000902 MO Practitioner - Anesthesiology 9931232154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Louisiana State University School of Medicine in New Orleans, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Missouri LLCGroup PAC ID 4082908249, 88 clinicians

Practice addresses (Care Compare)

100 Mercy Way
Joplin, MO 64804-4524
Phone (417) 556-3729

Hospital & facility affiliations

  • Mercy Hospital Joplin Hospital, Joplin, MO, CCN 260001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E0618ARMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Missouri, LLC Anesthesiology CurrentSince Dec 20, 2016 Accepting new patients
Northstar Anesthesia of Kentucky II, PLLC Anesthesiology Past Accepting new patients

Locations

3125 Dr Russell Smith Way
Carthage, MO 64836
Phone (417) 358-8121

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

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 and National Provider Directory roles.

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": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1477537306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6119 MIDTOWN AVE",
            "address_2": "SUITE 201",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055313",
            "telephone_number": "501-664-4532",
            "fax_number": "501-663-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6119 MIDTOWN AVE",
            "address_2": "SUITE 201",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055313",
            "telephone_number": "501-664-4532",
            "fax_number": "501-663-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "CARL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E0618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100079270A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131833001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.