CARLY ROARK (NPI# 1316478845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316478845 |
| Entity Type | Individual |
| Full Name | CARLY ROARK |
| Credential | M.D. |
| Practice Address |
625 United Dr Ste 360 Conway AR 72032-7831 |
| Practice Telephone | 5013586892 |
| Mailing Telephone | 5013586892 |
| Enumeration Date | 2017-03-26 |
| Last Update Date | 2020-06-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | E-13303 | AR | Allopathic & Osteopathic Physicians |
| Street Address |
625 UNITED DR STE 360 |
| City | CONWAY |
| State | AR |
| Zip Code | 72032-7831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346501020 | Curtis James Boyd IIi | Obstetrics & Gynecology | 625 United Dr Ste 360, Conway, AR 72032 | 2012-05-30 |
| 1508378241 | Arkansas Health Group | Obstetrics & Gynecology | 625 United Dr Ste 360, Conway, AR 72032-7826 | 2017-11-03 |
| 1306364039 | Arkansas Health Group | Obstetrics & Gynecology | 625 United Dr Ste 360, Conway, AR 72032-7826 | 2017-09-01 |
| 1306266226 | Brittanie Hagen | Obstetrics & Gynecology | 625 United Dr Ste 360, Conway, AR 72032-7831 | 2014-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730789843 | Amelia S Lasater | Pharmacist | 1155 Hwy 65n, Conway, AR 72032 | 2020-10-28 |
| 1619584604 | Danyelle Durocher | Occupational Therapist | 1301 North Museum Rd, Conway, AR 72032 | 2020-09-24 |
| 1780222174 | Eric Herman Boxnick | Pharmacist | 101 West Oak Street, Conway, AR 72032 | 2019-12-16 |
| 1932746070 | Habilitation Center, LLC | Psychiatric Residential Treatment Facility | 161 Skunk Hollow Road, Conway, AR 72032 | 2019-12-09 |
| 1679051668 | Mary Elizabeth Black | Nurse Practitioner | 222 Dave Ward Drive, Conway, AR 72032 | 2018-08-01 |
| 1275035602 | Conway Dental Center Pllc | Dentist | 1600 E. Oak Street Suite B, Conway, AR 72032 | 2018-03-01 |
| 1750821625 | Luke Osborne | Physical Therapy Assistant | 1 Thomas Ln, Conway, AR 72032 | 2017-02-27 |
| 1639620099 | Sam's West, Inc. | Technician/Technologist | 1250 South Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1922559343 | Sam's West, Inc. | Durable Medical Equipment & Medical Supplies | 1250 Sourth Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1639629108 | Posture Store | Durable Medical Equipment & Medical Supplies | 3900 Dave Ward Dr., Suite 1900-130, Conway, AR 72032 | 2016-10-09 |
| Find all providers in zip 72032 | ||||
| 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.