Stephen Blake, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT 3869 Issued in AR

Practice address

10901 N Rodney Parham Rd
Suite 7a
Little Rock, AR 72212-4114

Phone

(501) 301-4530

Fax

(501) 251-1165

NPI assigned

Aug 5, 2014

Last updated

Aug 5, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arkansas Pelvic Health PLLCGroup PAC ID 6002235421, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Arkansas Pelvic Health PLLC

  • Physical Therapist
  • Little Rock, AR
  • NPI 1346877214

  Orthopedic

  Medicare reassignment Care Compare group NPD
• Physical Therapy Institute

  • Physical Therapy Clinic/Center
  • Little Rock, AR
  • NPI 1497077648

  Orthopedic

  NPD (past)

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1568871556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10901 N RODNEY PARHAM RD",
            "address_2": "SUITE 7A",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722124114",
            "telephone_number": "501-301-4530",
            "fax_number": "501-251-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10901 N RODNEY PARHAM RD",
            "address_2": "SUITE 7A",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722124114",
            "telephone_number": "501-301-4530",
            "fax_number": "501-251-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "STEPHEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-05",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AR",
            "license": "PT 3869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARPT LICENSE 3869",
            "identifier": "PT 3869",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tykeira Blair
• Bethany Lynn Blake, DPT
• Bobbie Eliza Blake
• Lindsay Blake, EDD, MLIS
• Samantha Renea Blake, CNM, RN, IBCLC
• Jessica Blalock, RN
• Paulina K Blanc, DO
• Dylan Blancett, DPT
• Collie Marie Bland
• Jameelah Bland

• Orthopedic Physical Therapist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Orthopedic Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.