Organization Active NPI

Stubbs Center PLLC

Doing business as Stubbs Center for Cosmetic Surgery

  • Plastic and Reconstructive Surgery Physician
  • Fayetteville, AR
National Provider Identifier
1831957760
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
STUBBS CENTER PLLC
Doing business as
Stubbs Center for Cosmetic Surgery
Practice address
3654 N Investment Dr # 120
Fayetteville, AR 72703-5441
Phone
(216) 904-6596
NPI assigned
Mar 6, 2024
Last updated
Feb 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Authorized official

Name
Jessica Couch
Title
Office Manager
Phone
(216) 904-6596

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X NU Primary

Addresses

Primary practice location

3654 N Investment Dr # 120
Fayetteville, AR 72703-5441

Mailing address

3654 N Investment Dr # 120
Fayetteville, AR 72703-5441
Phone (479) 587-8756

Other names 1

  • Stubbs Center for Cosmetic Surgery Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240624000669 AR Part B Supplier - Clinic/Group Practice 2062955677 Receives reassigned benefits from 1 practitioner
Practice locations: Fayetteville, AR

National Provider Directory

National Provider Directory

Locations

3654 N Investment Dr
Ste 120
Fayetteville, AR 72703

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1831957760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3654 N INVESTMENT DR # 120",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035441",
            "telephone_number": "479-587-8756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3654 N INVESTMENT DR # 120",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035441",
            "telephone_number": "216-904-6596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STUBBS CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-06",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "COUCH",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "216-904-6596"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stubbs Center for Cosmetic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.