Active NPI
Stephanie Cherry Prock, AUDOLOGIST
- Audiologist
- Little Rock, AR
National Provider Identifier
1740322122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- A218
- Practice address
- 4300 W 7TH St
Little Rock, AR 72205-5446 - Phone
- (501) 257-5250
- NPI assigned
- Feb 13, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | A218 | AR | Primary |
Addresses
Primary practice location
4300 W 7TH St
Little Rock, AR 72205-5446
Mailing address
3115 E Kiehl Ave Ste B
Sherwood, AR 72120-3229
Phone (501) 833-8800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 795520637A | Medicaid | GA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A218 | AR | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462406400000",
"number": "1740322122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3115 E KIEHL AVE STE B",
"city": "SHERWOOD",
"state": "AR",
"postal_code": "721203229",
"telephone_number": "501-833-8800",
"fax_number": "501-833-8803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 W 7TH ST",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722055446",
"telephone_number": "501-257-5250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCK",
"first_name": "STEPHANIE",
"middle_name": "CHERRY",
"name_prefix": "Mrs.",
"credential": "AUDOLOGIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2016-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "AR",
"license": "A218",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "795520637A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.