CONWAY CHILDRENS CLINIC PA CORP (NPI# 1033170261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033170261 |
| Entity Type | Organization |
| Organization Name | CONWAY CHILDRENS CLINIC PA CORP |
| Practice Address |
2505 College Ave Conway AR 72034 |
| Practice Telephone | 5013276000 |
| Practice Fax Number | 5014507559 |
| Mailing Telephone | 5013276000 |
| Mailing Fax Number | 5014507559 |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2011-02-07 |
| Authorized Official Name | MR. MICHAEL A CONNAUGHTON (PRESIDENT) |
| Authorized Official Telephone | 5013276000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BLUE CROSS | 57800 | 01 |
| AR | 115903002 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003189606 | Conway Childrens Clinic Pa Corp | Clinic/Center | 10 Lois Lane, Greenbrier, AR 72058 | 2012-02-14 |
| Street Address |
2505 COLLEGE AVE |
| City | CONWAY |
| State | AR |
| Zip Code | 72034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427039049 | Kelly A Staley | Pediatrics | 2505 College Ave, Conway, AR 72034-6135 | 2005-11-10 |
| 1740713650 | Linda Christine Post | Nurse Practitioner | 2505 College Ave, Conway, AR 72034 | 2017-04-07 |
| 1801125216 | Deborah S Wingfield | Pediatrics | 2505 College Ave, Conway, AR 72034 | 2009-12-14 |
| 1114256872 | Lisa J. Martin | Pediatrics | 2505 College Ave, Conway, AR 72034 | 2009-12-09 |
| 1407099385 | Chris Killingsworth | Student in an Organized Health Care Education/Training Program | 2505 College Ave, Conway, AR 72034-6135 | 2009-04-08 |
| 1124120548 | Kirsten Leigh Kravitz | Nurse Practitioner | 2505 College Ave, Conway, AR 72034-6135 | 2006-09-05 |
| 1407838121 | Rhonda J Holland | Pediatrics | 2505 College Ave, Conway, AR 72034 | 2005-11-17 |
| 1316929037 | Dawn S Sutherland | Pediatrics | 2505 College Ave, Conway, AR 72034-6135 | 2005-11-17 |
| 1336120955 | Judy M Michaels | Pediatrics | 2505 College Ave, Conway, AR 72034-6135 | 2005-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013563758 | Shelby M Perez | Case Manager/Care Coordinator | 3240 Stermer Rd, Conway, AR 72034 | 2019-08-16 |
| 1467932772 | Faith J Parfait | Licensed Practical Nurse | 1352 Watkins St, Conway, AR 72034 | 2018-08-16 |
| 1043790611 | David Adam Steinfeld | Nurse Practitioner | 855 S German Ln Ste 1, Conway, AR 72034 | 2018-08-14 |
| 1245728484 | Conway Behavioral Health, LLC | Psychiatry & Neurology | 2255 Sturgis Rd, Conway, AR 72034 | 2018-04-24 |
| 1972007292 | Eldercare of Arkansas IIi, Inc. | Assisted Living Facility | 1306 S. Donaghey, Conway, AR 72034 | 2018-03-21 |
| 1528561404 | Kouhei Kobayashi | Specialist/Technologist | 2201 Moix Blvd., Apt. 908, Conway, AR 72034 | 2018-03-16 |
| 1780191015 | Sydnie Thessing | Nurse Practitioner | 605 Dave Ward Drive #105, Conway, AR 72034 | 2018-01-09 |
| 1508371865 | Ebony Latreace Charleston | Case Manager/Care Coordinator | 3240 Stermer Road, Conway, AR 72034 | 2017-12-08 |
| 1689190647 | Denise Annette Aikman | Dentist | 1210 Hogan Lane, Suite 200, Conway, AR 72034 | 2017-08-21 |
| 1134669138 | Hortons Orthotic Lab, Inc. | Prosthetic/Orthotic Supplier | 635 Dave Ward, Suite 103, Conway, AR 72034 | 2017-02-24 |
| Find all providers in zip 72034 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326591132 | Priya Yadav | Pediatrics | 3010 Fountain Dr, Conway, AR 72034-3684 | 2016-07-28 |
| 1417248063 | Caroline Duos Mazoch | Pediatrics | 2425 Dave Ward Dr Ste 601, Conway, AR 72034-8685 | 2011-04-29 |
| 1649584038 | Tlc Pediatrics, Pllc | Pediatrics | 955 Carolyn Ln, Conway, AR 72034-5015 | 2010-07-28 |
| 1174844708 | Danika Lauren Alexander Borden | Pediatrics | 300 Singleton Ridge Rd Ofc, Conway, SC 29526-9142 | 2010-06-17 |
| 1336465616 | Kelley Courtney Meena | Pediatrics | 605 Salem Rd Ste B2, Conway, AR 72034-4863 | 2010-04-12 |
| 1376758029 | Janell Thompson Vinson | Pediatrics | 625 United Dr Ste 120, Conway, AR 72032 | 2007-05-14 |
| 1366513608 | Stephen Alexander Corontzes | Pediatrics | 600 Singleton Ridge Rd, Conway, SC 29526-9154 | 2006-11-10 |
| 1285612671 | Terence L Champlin | Pediatrics | 605 Salem Rd, Suite B2, Conway, AR 72034-4861 | 2006-01-05 |
| 1174501563 | Sherrye Denise Craig | Pediatrics | 3010 Fountain Drive, Conway, AR 72034-3684 | 2006-01-05 |
| 1427039049 | Kelly A Staley | Pediatrics | 2505 College Ave, Conway, AR 72034-6135 | 2005-11-10 |
| Find all providers in CONWAY | ||||
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| 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.