Active NPI
Stanley E. Gately, M.D.
- Anesthesiology Physician
- Russellville, AR
National Provider Identifier
1497756407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- C6606
- Practice address
- 1808 W Main St
Russellville, AR 72801-2724 - Phone
- (479) 968-2841
- NPI assigned
- Aug 2, 2005
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | C6606 | AR | Primary |
Addresses
Primary practice location
1808 W Main St
Russellville, AR 72801-2724
Mailing address
PO Box 1351
Russellville, AR 72811-1351
Phone (800) 235-1415
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113710001 | Medicaid | AR | |
| 51200 | Other | AR | BLUE CROSS BLUE SHIELD AR |
| 050032849 | Other | RR MEDICAR GROUP CC5970 | |
| 770078101 | Other | AR | AR BREASTCARE |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C6606 | AR | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| River Valley Sleep Associates, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Anesthesiology Physician
- Russellville, AR
- NPI 1164644308
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212451200000",
"number": "1497756407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1351",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "728111351",
"telephone_number": "800-235-1415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1808 W MAIN ST",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "728012724",
"telephone_number": "479-968-2841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GATELY",
"first_name": "STANLEY",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-02",
"last_updated": "2008-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "AR",
"license": "C6606",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "113710001",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD AR",
"identifier": "51200",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICAR GROUP CC5970",
"identifier": "050032849",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AR BREASTCARE",
"identifier": "770078101",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Russellville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.