CONWAY REGIONAL MEDICAL CENTER, INC (NPI# 1043864093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043864093 |
| Entity Type | Organization |
| Organization Name | CONWAY REGIONAL MEDICAL CENTER, INC |
| Practice Address |
830 N Creek Dr Conway AR 72032-4711 |
| Practice Telephone | 5019320559 |
| Practice Fax Number | 5019320227 |
| Mailing Telephone | 5019320559 |
| Mailing Fax Number | 5019320227 |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2019-12-30 |
| Authorized Official Name | ALAN FINLEY (COO) |
| Authorized Official Telephone | 5014502114 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Conway Regional Interfaith Dental Clinic | 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 |
| 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 |
830 N CREEK DR |
| City | CONWAY |
| State | AR |
| Zip Code | 72032-4711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881612703 | Catholic Health Initiatives -st. Vincent Interfaith Clinic, Inc | Family Medicine | 830 N Creek Dr, Conway, AR 72032-4711 | 2006-07-18 |
| 1114447216 | Gary Jones | Dentist | 830 N Creek Dr, Conway, AR 72032-4711 | 2017-06-21 |
| 1750410569 | James Alfred Summitt | Dentist | 830 N Creek Dr, Conway, AR 72032-4711 | 2007-03-05 |
| 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 | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497310288 | Luke Fruchey | Dentist | 1125 S Amity Rd, Conway, AR 72032-8090 | 2019-05-07 |
| 1821591876 | Randy Lenderman Dds Plc | Dentist | 2425 Prince St Ste 1, Conway, AR 72034-3701 | 2018-03-15 |
| 1275035602 | Conway Dental Center Pllc | Dentist | 1600 E. Oak Street Suite B, Conway, AR 72032 | 2018-03-01 |
| 1427592732 | Axpm- Conway Dental Pllc | Dentist | 8 Medical Ln, Conway, AR 72034-4913 | 2016-12-06 |
| 1336502632 | Jebediah S. Christy, D.d.s - Conway, Pllc | Dentist | 2756 Church St, Conway, SC 29526 | 2016-04-04 |
| 1548642556 | Brooke Jeffus, Dds, Pllc | Dentist | 2235 Dave Ward Dr Ste 103, Conway, AR 72034-7040 | 2015-06-25 |
| 1316326028 | Jacob Seiter | Dentist | 2157 Prince St, Conway, AR 72034-3737 | 2015-05-27 |
| 1083032379 | East Oak Dental Pa | Dentist | 1600 E Oak St, Ste B, Conway, AR 72032 | 2014-04-03 |
| 1669800421 | Kidz Choice Conway LLC | Dentist | 2415 Prince St, Suite 105, Conway, AR 72034-3746 | 2013-10-14 |
| 1962782961 | Michael J Maser | Dentist | 1867 Highway 544 Unit B, Conway, SC 29526-8478 | 2011-08-22 |
| 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.