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KINDBODY OF AK MEDICAL PRACTICE, PC
NPI 1013647569
Obstetrics & Gynecology - Reproductive Endocrinology in Rogers, AR

Active since June 15, 2022CLIA 04D2265080 · Accreditation
2203 S PROMENADE BLVD STE 5185, ROGERS, AR 72758(855) 563-2639(646) 905-0987 Get Directions Write a Review

NPPES record last updated: May 20, 2024. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Kindbody Of Ak Medical Practice, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KINDBODY OF AK MEDICAL PRACTICE, PC (NPI 1013647569) is a healthcare organization registered as a reproductive endocrinology in Rogers, Arkansas and active in the NPI registry since June 2022. The organization holds an CLIA Accreditation certificate valid through April 30, 2028 and lists Fahimeh Sasan, Founding Obgyn, as its authorized official.

NPPES Registry Identity

NPI1013647569
Entity TypeOrganization
Primary Taxonomy207VE0102X
Legal Business NamePEACH STATE MEDICAL PRACTICE, PC
Location Address2203 S PROMENADE BLVD STE 5185Rogers, AR 72758-8722
Mailing Address333 S Desplaines St Ste 201Chicago, IL 60661-5514 · (855) 563-2639
Phone(855) 563-2639
Fax(646) 905-0987
Organization SubpartNo
Authorized OfficialFahimeh SasanFounding Obgyn · (855) 563-2639
Enumeration DateJune 15, 2022
Last NPPES UpdateMay 20, 2024
NPPES CertifiedMay 20, 2024
✔ NPI 1013647569 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & Gynecology · Reproductive EndocrinologyAllopathic & Osteopathic Physicians
Taxonomy Code207VE0102X
Definition
An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility.
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
2203 S PROMENADE BLVD STE 5185, Rogers, AR 72758
Open in Google Maps ↗

Other Names 1

Doing Business AsKindbody Of Ak Medical Practice, Pc

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 04D2265080

Kindbody Of Ar Medical Practice · Rogers, AR
Active · expires Apr 30, 2028
CLIA Number04D2265080
Laboratory TypePhysician Office
Certificate Effective DateMay 1, 2026
Certificate Expiration DateApril 30, 2028
Laboratory DirectorDr. Tariq A. Shah
Laboratory Phone(855) 563-2639
Laboratory LocationKindbody Of Ar Medical Practice2203 S Promenade Blvd, Suite #5185, Rogers, AR 72758
CLIA data matches this NPI record on: Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZABETH A WILSON APRN-CNP
Nurse Practitioner
2203 S PROMENADE BLVD STE 5185
ROGERS, AR 72758
Benton County (479) 480-7200
RACHEL E FARRELL MD
Obstetrics & Gynecology
2203 S PROMENADE BLVD STE 5185
ROGERS, AR 72758
Benton County (479) 480-7200
MCKENZIE LYNN STOCK APRN
Nurse Practitioner (Family)
2203 S PROMENADE BLVD STE 5185
ROGERS, AR 72758
Benton County (407) 552-1035
MS. LAURA GREMILLION LARGENT CNM, WHNP
Nurse Practitioner (Women's Health)
2203 S PROMENADE BLVD STE 5185
ROGERS, AR 72758
Benton County (479) 480-7200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Peach State Medical Practice, PC's NPI number?

The NPI number for Peach State Medical Practice, PC is 1013647569. It was assigned to this organization in the NPPES registry on June 15, 2022. The provider is doing business as Kindbody Of Ak Medical Practice, PC.

Where is Peach State Medical Practice, PC located?

Peach State Medical Practice, PC is located at 2203 S Promenade Blvd Ste 5185, Rogers, AR 72758. The listed phone number is (855) 563-2639.

What is Peach State Medical Practice, PC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Reproductive Endocrinology, with taxonomy code 207VE0102X.

Does Peach State Medical Practice, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 04D2265080) is associated with this NPI, valid through April 30, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Peach State Medical Practice, PC was last updated on May 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.