DEANDRE DESHAWN GRIDER (NPI# 1457871899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457871899 |
| Entity Type | Individual |
| Full Name | DEANDRE DESHAWN GRIDER |
| Practice Address |
2740 College Ave Conway AR 72034-6141 |
| Practice Telephone | (501) 329-5459 |
| Practice Fax Number | 5013271738 |
| Mailing Telephone | 5013295459 |
| Mailing Fax Number | 5013271738 |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2017-06-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 373H00000X | Day Training/Habilitation Specialist | Nursing Service Related Providers |
| Street Address |
2740 COLLEGE AVE |
| City | CONWAY |
| State | AR |
| Zip Code | 72034-6141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841380789 | Leah M Lowe | Physical Therapist | 2740 College Ave, Conway, AR 72034-6141 | 2006-10-13 |
| 1821695628 | Hannah J Cleveland | Day Training/Habilitation Specialist | 2740 College Ave, Conway, AR 72034-6141 | 2020-10-05 |
| 1821606138 | Meredith Hammontree | Registered Nurse | 2740 College Ave, Conway, AR 72034-6141 | 2020-07-22 |
| 1568085389 | Casey L Slayton | Registered Nurse | 2740 College Ave, Conway, AR 72034-6141 | 2020-05-27 |
| 1932720141 | Gabrielle Ashtyn Hern | Day Training/Habilitation Specialist | 2740 College Ave, Conway, AR 72034-6141 | 2020-04-28 |
| 1356970511 | Wesley Elaine Moreno Robles | Behavior Technician | 2740 College Ave, Conway, AR 72034-6141 | 2020-04-08 |
| 1104459056 | Kelby Bolling | Behavioral Analyst | 2740 College Ave, Conway, AR 72034-6141 | 2020-02-19 |
| 1689211328 | Seth Christopher Hunter | Behavior Technician | 2740 College Ave, Conway, AR 72034-6141 | 2019-12-02 |
| 1497306757 | Mia Harper | Behavior Technician | 2740 College Ave, Conway, AR 72034-6141 | 2019-09-26 |
| 1669023925 | Jason Tulberg | Behavior Technician | 2740 College Ave, Conway, AR 72034-6141 | 2019-09-26 |
| 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 | 373H00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Day Training/Habilitation Specialist |
| Individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills that enable them to cope more effectively with the demands of independent living. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679691117 | Humble Hearts Care Service | Day Training/Habilitation Specialist | 652 State Rd M, Conway, MO 65632 | 2007-03-26 |
| 1821695628 | Hannah J Cleveland | Day Training/Habilitation Specialist | 2740 College Ave, Conway, AR 72034-6141 | 2020-10-05 |
| 1932720141 | Gabrielle Ashtyn Hern | Day Training/Habilitation Specialist | 2740 College Ave, Conway, AR 72034-6141 | 2020-04-28 |
| 1649828823 | Hannah Kate Howard | Day Training/Habilitation Specialist | 2740 College Ave, Conway, AR 72034-6141 | 2019-08-30 |
| 1467988204 | Sydney Cummings | Day Training/Habilitation Specialist | 2740 College Ave, Conway, AR 72034-6141 | 2017-05-11 |
| 1730614389 | Ashlee Sharp | Day Training/Habilitation Specialist | 2740 College Ave, Conway, AR 72034-6141 | 2017-04-20 |
| 1447704028 | Brandon Shelley | Day Training/Habilitation Specialist | 2740 College Ave, Conway, AR 72034-6141 | 2016-08-11 |
| 1093269698 | Kathy Tullous | Day Training/Habilitation Specialist | 2740 College Ave, Conway, AR 72034-6141 | 2016-08-11 |
| 1114471828 | Alyndria Mooney | Day Training/Habilitation Specialist | 2740 College Ave, Conway, AR 72034-6141 | 2016-08-10 |
| 1851844369 | Ashley Williams | Day Training/Habilitation Specialist | 2740 College Ave, Conway, AR 72034-6141 | 2016-08-01 |
| 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.