ANNETTE N. ANDERSON, MD, PA (NPI# 1558667683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558667683 |
| Entity Type | Organization |
| Organization Name | ANNETTE N. ANDERSON, MD, PA |
| Practice Address |
2425 Dave Ward Dr Suite 102 Conway AR 72034-8686 |
| Mailing Address |
14008 Windsor Rd Little Rock AR 72212-3201 |
| Practice Telephone | 5019320480 |
| Practice Fax Number | 5019320106 |
| Mailing Telephone | 5012278311 |
| Mailing Fax Number | 5012278311 |
| Enumeration Date | 2011-02-08 |
| Last Update Date | 2011-02-08 |
| Authorized Official Name | ANNETTE NICOLE ANDERSON (PRESIDENT) |
| Authorized Official Telephone | 5012278311 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
Allopathic & Osteopathic Physicians |
| Street Address |
2425 DAVE WARD DR SUITE 102 |
| City | CONWAY |
| State | AR |
| Zip Code | 72034-8686 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801884622 | Jeffrey P Kirsch | Specialist | 2425 Dave Ward Dr, Ste 101, Conway, AR 72034-8686 | 2005-10-06 |
| 1467089599 | Conway Ambulatory Surgery Center, LLC | Clinic/Center | 2425 Dave Ward Dr, Conway, AR 72034-8686 | 2020-03-26 |
| 1114461118 | Leah Marie Lamb | Pharmacist | 2425 Dave Ward Dr, Suite 602, Conway, AR 72034-8686 | 2016-12-09 |
| 1962862557 | Rachel Choate | Nurse Practitioner | 2425 Dave Ward Dr, Suite 202, Conway, AR 72034-8686 | 2016-02-25 |
| 1992180269 | Natalie Claire Brownd | Nurse Practitioner | 2425 Dave Ward Dr, Suite #401, Conway, AR 72034-8686 | 2015-07-28 |
| 1871990937 | The Pain Medicine Consultants Group | Durable Medical Equipment & Medical Supplies | 2425 Dave Ward Dr, Gordy Building Ste 102, Conway, AR 72034-8686 | 2014-12-04 |
| 1851697197 | Jaclyn J Cooper | Nurse Practitioner | 2425 Dave Ward Dr, Suite 601, Conway, AR 72034-8686 | 2011-02-03 |
| 1902043227 | Saint-mark Enterprises 1890 LLC | Pharmacy | 2425 Dave Ward Dr, Suite 602, Conway, AR 72034-8686 | 2009-01-08 |
| 1558536219 | Kathleen E. Phillips | Audiologist | 2425 Dave Ward Dr, Suite 101, Conway, AR 72034-8686 | 2008-04-24 |
| 1740481274 | Trudy Davis Forbush | Physical Therapist | 2425 Dave Ward Dr, Conway, AR 72034-8686 | 2007-05-31 |
| Find all providers in the same location | ||||
| 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 | 2084P0805X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Geriatric Psychiatry |
| Geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811170301 | Annette N. Anderson | Psychiatry & Neurology | 495 Hogan Ln Ste 2, Conway, AR 72034-8498 | 2007-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184674962 | Michael G Hollomon | Psychiatry & Neurology | 601 W Maple, Suite 403, Springdale, AR 72764-5374 | 2006-05-11 |
| 1902856867 | Gary A Linker | Psychiatry & Neurology | 12 E Appleby, Suite 101, Fayetteville, AR 72703 | 2006-05-11 |
| 1548230550 | Graham Mack Reid | Psychiatry & Neurology | 10816 Executive Center Dr, Suite 101, Little Rock, AR 72211-4384 | 2006-01-23 |
| 1306843396 | William Martin Meaney | Psychiatry & Neurology | 907 Mena St, Mena, AR 71953-4247 | 2005-07-05 |
| 1083932362 | Margaret Amanda Ege-woolley | Psychiatry & Neurology | 4301 W Markham St, Mail Slot 552, Little Rock, AR 72205-7101 | 2010-05-11 |
| 1174644140 | Joshua Woolley | Psychiatry & Neurology | 2200 Fort Roots Dr, Building 170 Unit 1l, North Little Rock, AR 72114-1709 | 2007-04-03 |
| 1154411627 | Lou Eads | Psychiatry & Neurology | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2006-10-13 |
| 1336253533 | Monica Rohde Shotwell | Psychiatry & Neurology | 2200 Fort Roots Dr, Bldg 170, Ward 1h, North Little Rock, AR 72114-1709 | 2006-08-18 |
| 1366458044 | Dinesh Mittal | Psychiatry & Neurology | 2200 Fort Roots Dr, Building 58 (152/nlr), North Little Rock, AR 72114-1709 | 2006-08-01 |
| 1366408973 | Washington Regional Medical System | Psychiatry & Neurology | 3215 N Northhills Blvd, Washington Regional Psychiatric Clinic, Fayetteville, AR 72703-4424 | 2006-04-22 |
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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.