CONWAY REGIONAL MEDICAL CENTER, INC (NPI# 1730402249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730402249 |
| Entity Type | Organization |
| Organization Name | CONWAY REGIONAL MEDICAL CENTER, INC |
| Other Organization Name | CONWAY REGIONAL COUNSELING CENTER |
| Practice Address |
495 Hogan Ln Ste 2 Conway AR 72034-8498 |
| Mailing Address |
Po Box 9662 Conway AR 72033-9662 |
| Practice Telephone | 5013586695 |
| Practice Fax Number | 5013586860 |
| Mailing Telephone | 5013586695 |
| Mailing Fax Number | 5013586860 |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | MR. TROY BROOKS (CHIEF FINANCIAL OFFICE) |
| Authorized Official Telephone | 5014502112 |
| Is Organization Subpart | Y |
| Parent Organization Name | CONWAY REGIONAL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AARP HEALTHCARE-UHC | 5000028 | 01 | |
| AETNA | 0607495 | 01 | |
| AR | BLUE CROSS BLUE SHIELD | 10029 | 01 |
| UNITED HEALTHCARE | 124633 | 01 | |
| HEALTHLINK-HMO | 107347 | 01 | |
| UNITED HEALTHCARE | 1110762 | 01 | |
| CIGNA HEALTHCARE OF AR | 10015 | 01 |
| Other Name | Type Code |
|---|---|
| CONWAY REGIONAL COUNSELING CENTER | Doing Business As Name - Organization |
| Conway Regional Senior Evaluation & Counseling Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710513957 | Conway Regional Medical Center, Inc | Family Medicine | 1700 Altus St Ste 110, Conway, AR 72032-4299 | 2020-03-19 |
| 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 |
| Street Address |
495 HOGAN LN STE 2 |
| City | CONWAY |
| State | AR |
| Zip Code | 72034-8498 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811170301 | Annette N. Anderson | Psychiatry & Neurology | 495 Hogan Ln Ste 2, Conway, AR 72034-8498 | 2007-12-07 |
| 1245647494 | Mary Christine Dumboski | Nurse Practitioner | 495 Hogan Ln Ste 2, Conway, AR 72034-8498 | 2014-07-21 |
| 1386908762 | Robbie Linn Hurtt | Urology | 495 Hogan Ln Ste 2, Conway, AR 72034-8498 | 2012-06-29 |
| 1912177486 | Londa Lynne Revis | Social Worker | 495 Hogan Ln Ste 2, Conway, AR 72034-8498 | 2008-03-11 |
| 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 | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427679919 | All Are Welcome Counseling | Clinic/Center | 2669 Pecan Ln, Conway, SC 29526-6610 | 2020-05-06 |
| 1619501657 | Bhg L, LLC | Clinic/Center | 1058 Front St Ste 104, Conway, AR 72032-4337 | 2020-02-28 |
| 1447884705 | Jennie Cassidy Psychologist LLC | Clinic/Center | 1511 9th Ave Ste C, Conway, SC 29526-4126 | 2020-02-26 |
| 1528508108 | Conway Behavioral Health, LLC | Clinic/Center | 2255 Sturgis Road, Conway, AR 72034-8334 | 2017-03-02 |
| 1669887808 | Counseling and Assessment Clinic Pllc | Clinic/Center | 306 Salem Rd Ste 109, Conway, AR 72034-6376 | 2014-06-26 |
| 1417109703 | Counseling Associates, Inc | Clinic/Center | 855 S Salem Rd, Conway, AR 72034-8365 | 2008-10-17 |
| 1326290610 | Counseling Associates, Inc | Clinic/Center | 1701 Donaghey Ave, Conway, AR 72032-2511 | 2008-10-17 |
| 1811502271 | Aich Counseling, LLC | Clinic/Center | 915 Oak St Ste 103, Conway, AR 72032-4389 | 2020-09-12 |
| 1093362881 | Waccamaw Center for Mental Health | Clinic/Center | 164 Waccamaw Medical Park Dr, Conway, SC 29526-8903 | 2019-08-26 |
| 1548704521 | Because You Matter Counseling Pllc | Clinic/Center | 21 Macarthur Dr, Conway, AR 72032-4510 | 2016-12-11 |
| 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.