Individual provider Active NPI

Jennifer S Gregory, MD

  • Obstetrics & Gynecology Physician
  • Little Rock, AR
National Provider Identifier
1710008784
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
E-6425 Issued in AR
Practice address
9500 Kanis Rd Ste 200
Little Rock, AR 72205-6358
Phone
(501) 224-6699
Fax
(501) 224-7752
NPI assigned
Apr 3, 2007
Last updated
Feb 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X E6425 AR
Obstetrics & Gynecology Physician 207V00000X E-6425 AR Primary

Addresses

Primary practice location

9500 Kanis Rd Ste 200
Little Rock, AR 72205-6358

Mailing address

11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (501) 221-6699

Other identifiers 2

IdentifierTypeStateIssuer
E6425OtherARLICENSE
1710008784OtherINDIVIDUAL NPI

Other names 1

  • Jenniger Short Former name

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
I20100929001149 AR Practitioner - Obstetrics/Gynecology 1557487337 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Arkansas College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Women's Center, PAGroup PAC ID 5597784090, 5 clinicians

Practice addresses (Care Compare)

9500 Kanis Rd
Suite 200
Little Rock, AR 72205-6358
Phone (501) 224-6699

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E6425ARMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Women's Center PA Obstetrics & Gynecology CurrentSince Mar 1, 2021 Accepting new patients
Baptist Medcare, Inc CurrentSince Jul 1, 2021 Accepting new patients

Locations

3050 Twin Rivers Dr
Arkadelphia, AR 71923
Phone (501) 202-2300

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

9500 Kanis Rd
Ste 200
Little Rock, AR 72205
Phone (501) 224-6699

9601 Baptist Health Dr
Little Rock, AR 72205
Phone (501) 202-3995

Interoperability endpoints

  • Direct secure messaging: jgregory5262@direct.baptist-healthar.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1710008784",
    "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": "501-221-6699",
            "fax_number": "501-221-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 KANIS RD STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056358",
            "telephone_number": "501-224-6699",
            "fax_number": "501-224-7752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AR",
            "license": "E6425",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AR",
            "license": "E-6425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "E6425",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1710008784",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIGER",
            "last_name": "SHORT",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.