CONWAY CHILDRENS CLINIC PA CORP (NPI# 1003189606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003189606 |
| Entity Type | Organization |
| Organization Name | CONWAY CHILDRENS CLINIC PA CORP |
| Other Organization Name | GREENBRIER CHILDRENS CLINIC |
| Practice Address |
10 Lois Lane Greenbrier AR 72058 |
| Practice Telephone | 5016796796 |
| Mailing Telephone | 5016796796 |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2012-02-14 |
| Authorized Official Name | MICHAEL CONNAUGHTON (OWNER/MD) |
| Authorized Official Telephone | 5013276000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CMS# | 043872 | 01 |
| Other Name | Type Code |
|---|---|
| Greenbrier Childrens Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033170261 | Conway Childrens Clinic Pa Corp | Pediatrics | 2505 College Ave, Conway, AR 72034 | 2006-03-29 |
| Street Address |
10 LOIS LANE |
| City | GREENBRIER |
| State | AR |
| Zip Code | 72058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487296570 | Lauren Michelle Davis | Pharmacist | 61a South Broadview Street, Greenbrier, AR 72058 | 2019-10-10 |
| 1851941751 | Carmen M. Crawford | Technician | 129 Mill Creek Dr., Greenbrier, AR 72058 | 2019-09-13 |
| 1659935476 | Thomas A Bradley | Nurse Practitioner | 20 Wilson Farm Rd, Greenbrier, AR 72058 | 2019-04-26 |
| 1235614421 | Greenbrier Pharmacy Inc | Pharmacy | 61a South Broadview St, Greenbrier, AR 72058 | 2018-10-03 |
| 1912453127 | Sarah Ellington | Speech-Language Pathologist | 8 Wilson Farm Rd Suite F, Greenbrier, AR 72058 | 2016-08-28 |
| 1487056628 | Tammy Dallari | Occupational Therapist | 92 A S Broadview St, Greenbrier, AR 72058 | 2014-09-18 |
| 1427300953 | Elizabeth Mcclelland | Occupational Therapist | 92 A South Broadveiw, Hwy 65, Greenbrier, AR 72058 | 2012-10-08 |
| 1891040564 | Kristina Mcgee | Speech-Language Pathologist | 92 South Broadveiw, Hwy 65, Greenbrier, AR 72058 | 2012-07-19 |
| 1861797813 | Harps Food Stores Inc | Pharmacy | 15 North Broadview Street, Greenbrier, AR 72058 | 2011-01-24 |
| 1609103373 | Jennifer Harmon | Occupational Therapist | 92 A South Broadview, Greenbrier, AR 72058 | 2009-11-17 |
| Find all providers in zip 72058 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942375639 | Conway Regional Medical Center Inc | Clinic/Center | 110 N Broadview St, Greenbrier, AR 72058-9475 | 2006-11-21 |
| 1548362437 | Conway Regional Medical Center Inc | Clinic/Center | 110 N Broadview, Greenbrier, AR 72058-9475 | 2006-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634738 | Mississippi County Hospital System | Clinic/Center | 1521 N 10th St Ste G, Blytheville, AR 72315-1424 | 2020-09-18 |
| 1962015859 | Lansdell Family Clinic Pllc | Clinic/Center | 1124 Main Ave, Dierks, AR 71833-9421 | 2020-08-28 |
| 1154945483 | Sgoh Acquisition Inc | Clinic/Center | 102 Russell Road, Rogers, AR 72756 | 2020-06-02 |
| 1710465190 | Arcare | Clinic/Center | 3150 E. Heritage Parkway, Farmington, AR 72753 | 2018-07-30 |
| 1043716525 | Mmc Rural Health Clinics, Pllc | Clinic/Center | 733 Roberts Drive, Monticello, AR 71655 | 2018-04-03 |
| 1316443807 | Mmc Rural Health Clinics, Pllc | Clinic/Center | 1306 North Lincoln Avenue, Star City, AR 71667 | 2018-04-03 |
| 1124539648 | Access Medical Clinic Arkansas LLC | Clinic/Center | 1016 North Fourche Avenue, Perryville, AR 72126 | 2017-10-24 |
| 1174044697 | Bradley County Medical Center Rural Health Clinic | Clinic/Center | 304 East Central, Warren, AR 71671-0000 | 2017-07-06 |
| 1144755570 | Access Medical Clinic Arkansas LLC | Clinic/Center | 16723 Hwy 62, Garfield, AR 72732 | 2017-04-24 |
| 1568904480 | Bradley Bibb, Md Pllc | Clinic/Center | 1176 State Highway 22 W Ste B, Dardanelle, AR 72834 | 2016-11-09 |
| Find all providers with the same taxonomy | ||||
| City | GREENBRIER |
| Zip Code | 72058 |
Please comment or provide details below to improve the information on CONWAY CHILDRENS CLINIC PA CORP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.