Individual provider Active NPI

Cody Ray Grant

  • Certified Registered Nurse Anesthetist
  • Little Rock, AR
National Provider Identifier
1972768596
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
126162 Issued in AR
Practice address
4301 W Markham St
Little Rock, AR 72205-7101
Phone
(501) 686-7000
NPI assigned
Jul 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 126162 AR Primary

Addresses

Primary practice location

4301 W Markham St
Little Rock, AR 72205-7101

Mailing address

4301 W Markham St
Little Rock, AR 72205-7101

Other practice location 1

6701 Highway 67
Benton, AR 72015-8909
Phone (501) 315-3344

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190710001755 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779818950 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Arkansas for Medical SciencesGroup PAC ID 4082528955, shared by 29 NPIs, 1,159 clinicians

Practice addresses (Care Compare)

4301 W Markam St
Little Rock, AR 72205-7101

Hospital & facility affiliations

  • University of Arkansas Medical Sciences Hospital, Little Rock, AR, CCN 040016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
126162ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2019 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2019 Accepting new patients
Gastro Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 25, 2021 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2019 Accepting new patients
St. Vincent Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Southern Regional Anesthesiology Consultants PLLC CurrentSince Aug 12, 2021 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 29, 2021 Accepting new patients

Locations

700 W Grove St
El Dorado, AR 71730
Phone (870) 863-2200

300 Werner St
Hot Springs National Park, AR 71913
Phone (501) 622-1000

500 S University Ave
Ste 500
Little Rock, AR 72205
Phone (501) 320-1101

1024 N University Ave
Little Rock, AR 72207
Phone (501) 537-0900

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

16221 Saint Vincent Way
Little Rock, AR 72223
Phone (501) 221-0888

405 N University Ave
Little Rock, AR 72205
Phone (501) 228-4445

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

4 Hospital Dr
Morrilton, AR 72110
Phone (501) 977-2300

Organizations & group practices 9

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

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": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1972768596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6701 Highway 67",
            "address_purpose": "LOCATION",
            "city": "Benton",
            "state": "AR",
            "postal_code": "720158909",
            "country_code": "US",
            "telephone_number": "501-315-3344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT",
        "first_name": "CODY",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-23",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "126162",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 26, 2019; 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.