CONWAY REGIONAL MEDICAL CENTER, INC (NPI# 1710513957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710513957 |
| Entity Type | Organization |
| Organization Name | CONWAY REGIONAL MEDICAL CENTER, INC |
| Other Organization Name | CONWAY REGIONAL HENDRIX MEDICAL CLINIC |
| Practice Address |
1700 Altus St Ste 110 Conway AR 72032-4299 |
| Practice Telephone | 5018521366 |
| Practice Fax Number | 5018521367 |
| Mailing Telephone | 5018521366 |
| Mailing Fax Number | 5018521367 |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2020-05-18 |
| Authorized Official Name | MR. TROY BROOKS (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5014502112 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Conway Regional Hendrix Medical Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376054155 | Conway Regional Medical Center, Inc | Internal Medicine | 2200 Ada Ave Ste 201, Conway, AR 72034-4984 | 2017-10-19 |
| 1043864093 | Conway Regional Medical Center, Inc | Dentist | 830 N Creek Dr, Conway, AR 72032-4711 | 2019-07-29 |
| 1003478462 | Conway Regional Medical Center, Inc | Internal Medicine | 525 Western Ave Ste 305, Conway, AR 72034-4982 | 2019-07-05 |
| 1245729359 | Conway Regional Medical Center, Inc | Family Medicine | 108 Skyline Dr, Russellville, AR 72801-3362 | 2018-05-03 |
| 1942713987 | Conway Regional Medical Center, Inc | Clinic/Center | 525 Western Ave Ste 304, Conway, AR 72034-4981 | 2017-11-13 |
| 1851796676 | Conway Regional Medical Center, Inc | Family Medicine | 437 Denison St, Suite 2, Conway, AR 72034-6127 | 2014-10-23 |
| 1588975825 | Conway Regional Medical Center, Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 525 Western Ave, Suite 302, Conway, AR 72034-4967 | 2010-07-01 |
| 1730402249 | Conway Regional Medical Center, Inc | Clinic/Center | 495 Hogan Ln Ste 2, Conway, AR 72034-8498 | 2010-03-11 |
| Street Address |
1700 ALTUS ST STE 110 |
| City | CONWAY |
| State | AR |
| Zip Code | 72032-4299 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912543240 | University of Central Arkansas | Family Medicine | 201 Donaghey Ave Uca Student Health Center, Conway, AR 72035-5001 | 2019-11-21 |
| 1588012728 | Arkansas Health Group | Family Medicine | 625 United Dr Ste 120a, Conway, AR 72032-7826 | 2016-05-27 |
| 1477999282 | Michael Paul Carson | Family Medicine | 605 United Dr, Conway, AR 72032 | 2013-05-20 |
| 1427335835 | Brieanna R Breeding | Family Medicine | 2100 Meadowlake Rd Ste 10, Conway, AR 72032-2569 | 2011-11-14 |
| 1710217104 | Billy R Mcbay Md Pa | Family Medicine | 505 E Dave Ward Dr, Ste 3, Conway, AR 72032-7825 | 2010-01-06 |
| 1417118076 | Alexander Tyler | Family Medicine | 455 Elsinger Blvd, Conway, AR 72032-4716 | 2008-06-17 |
| 1336317593 | James L Floyd Jr. | Family Medicine | 128a Professional Park Place, Agape Physicians Care, Conway, SC 29526-9260 | 2008-02-11 |
| 1326246190 | Thad Ridge Hardin | Family Medicine | 2425 Dave Ward Dr Ste 401, Conway, AR 72034 | 2007-07-03 |
| 1235336959 | James Austin Capps Jr. | Family Medicine | Conway Interfaith Clinic, Inc, 830 North Creek Drive, Conway, AR 72032 | 2007-06-27 |
| 1164529525 | Betty A Jones | Family Medicine | 1608 N Main Street, Conway, SC 29526-3572 | 2006-09-20 |
| 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.