Active NPI
Stanley Michael Rest, PHD
- Clinical Psychologist
- Springdale, AR
National Provider Identifier
1871521476
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective May 18, 2017.
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 31-94P
- Practice address
- 2400 S 48TH St
Springdale, AR 72762-6683 - Phone
- (479) 750-2020
- Fax
- (479) 750-8967
- NPI assigned
- Jun 30, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 31-94P | AR | Primary |
Addresses
Primary practice location
2400 S 48TH St
Springdale, AR 72762-6683
Mailing address
PO Box 6430
Springdale, AR 72766-6430
Phone (479) 750-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5S864 | Other | AR | BLUE SHIELD PROVIDER # |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31-94P | AR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392940800000",
"number": "1871521476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6430",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727666430",
"telephone_number": "479-750-2020",
"fax_number": "479-750-1739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 S 48TH ST",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727626683",
"telephone_number": "479-750-2020",
"fax_number": "479-750-8967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REST",
"first_name": "STANLEY",
"middle_name": "MICHAEL",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2014-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AR",
"license": "31-94P",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD PROVIDER #",
"identifier": "5S864",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.