CONWAY HOSPITAL COMMUNITY SERVICES (NPI# 1467698076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1467698076 |
Entity Type | Organization |
Organization Name | CONWAY HOSPITAL COMMUNITY SERVICES |
Other Organization Name | CPG FAMILY MEDICINE AT SINGLETON RIDGE |
Practice Address |
124 Professional Park Dr Suite A Conway SC 29526-9260 |
Mailing Address |
300 Singleton Ridge Rd Attention Patient Accounting Conway SC 29526-9142 |
Practice Telephone | 8433479500 |
Practice Fax Number | 8433479595 |
Mailing Telephone | 8432346946 |
Mailing Fax Number | 8432348958 |
Enumeration Date | 2009-01-02 |
Last Update Date | 2020-03-02 |
Authorized Official Name | BRET BARR (CEO) |
Authorized Official Telephone | 8433478114 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2336 | SC | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
SC | GP4505 | 05 |
Other Name | Type Code |
---|---|
CPG Family Medicine at Singleton Ridge | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467772400 | Conway Hospital Community Services | Clinic/Center | 1213 Elm Street, Aynor, SC 29511 | 2010-06-01 |
1043632805 | Conway Hospital Community Services | Obstetrics & Gynecology | 8004 Myrtle Trace Dr, Conway, SC 29526-8945 | 2014-01-14 |
1821335068 | Conway Hospital Community Services | Family Medicine | 51 11th Ave, Aynor, SC 29511-3249 | 2013-01-08 |
1689928103 | Conway Hospital Community Services | Family Medicine | 300 Singleton Ridge Rd, Conway, SC 29526-9142 | 2012-11-06 |
1518268317 | Conway Hospital Community Services | Surgery | 2376 Cypress Cir, Suite 103, Conway, SC 29526-8964 | 2010-11-10 |
1306166012 | Conway Hospital Community Services | Clinic/Center | 1301 Creel St, Conway, SC 29527-5018 | 2010-06-03 |
1033244793 | Conway Hospital Community Services | Internal Medicine | 300 Singleton Ridge Rd, Conway, SC 29526-9142 | 2007-02-22 |
1801955141 | Conway Hospital Community Services | Family Medicine | 1213 Elm St, Aynor, SC 29511-3320 | 2006-12-06 |
Street Address |
124 PROFESSIONAL PARK DR SUITE A |
City | CONWAY |
State | SC |
Zip Code | 29526-9260 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508238015 | Instride Foot and Ankle Specialists, Pllc | Podiatrist | 124 Professional Park Dr, Conway, SC 29526-9260 | 2015-10-23 |
1558701128 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 124 Professional Park Dr, Suite A, Conway, SC 29526-9260 | 2013-06-27 |
1588800890 | Amanda J Bruce | Nurse Practitioner | 124 Professional Park Dr, Ste A, Conway, SC 29526-9260 | 2008-12-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457975237 | Terri L Champion | Massage Therapist | 172 Waccamaw Medical Park Court, Conway, SC 29526 | 2020-06-08 |
1689204398 | Alayna Defalco | Clinical Exercise Physiologist | 1320 501 Business, Unit E, Conway, SC 29526 | 2020-01-22 |
1124672662 | Proxsys Rx - Sc, LLC | Pharmacy | 300 Singelton Ridge Road, Conway, SC 29526 | 2019-08-01 |
1598227431 | Surgery Center of Conway Inc | Clinic/Center | 1405 Main Street, Conway, SC 29526 | 2019-04-01 |
1801374962 | Trevor James Hess | Specialist/Technologist | 905 One Landon Loop, Conway, SC 29526 | 2018-08-01 |
1851800817 | Katherine Ann Nimphius | Behavioral Analyst | 105 Timberline Dr, Conway, SC 29526 | 2017-09-21 |
1922544253 | William Houck | Specialist/Technologist | 925 One Landon Loop, Conway, SC 29526 | 2017-01-10 |
1952857278 | Courtney Jeanette Smith | Counselor | 164 Waccamaw Medical Park Dr., Conway, SC 29526 | 2016-08-28 |
1336502632 | Jebediah S. Christy, D.d.s - Conway, Pllc | Dentist | 2756 Church St, Conway, SC 29526 | 2016-04-04 |
1447615208 | Abl Enterprises, LLC | Optometrist | 113 Citadel Drive, Conway, SC 29526 | 2015-12-22 |
Find all providers in zip 29526 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023617594 | Mckenzie Lauren Cotton | Nurse Practitioner | 1065 Skyline Dr, Conway, AR 72032-3530 | 2020-10-25 |
1316566607 | Shannon Busby | Nurse Practitioner | 1505 Winterbrook Dr, Conway, AR 72034-3564 | 2020-04-16 |
1538798087 | Glenda Darlene Gore | Nurse Practitioner | 17 Kali Ct, Conway, AR 72032-9477 | 2020-04-06 |
1265071427 | Dana Aysha Niederhauser | Nurse Practitioner | 1250 Littlewood Cv, Conway, AR 72032-8986 | 2020-01-04 |
1285287680 | Joy Griffith | Nurse Practitioner | 2907 Percy Cir, Conway, AR 72034-5508 | 2019-07-24 |
1366094260 | Kerry Kathryn Lewis | Nurse Practitioner | 1910 Royal Dr, Conway, AR 72034-7346 | 2019-07-10 |
1487113148 | Laura B Kelly | Nurse Practitioner | 2300 Linda Dr, Conway, AR 72032-8999 | 2019-03-12 |
1780141069 | Ashleigh Lynn Kinon | Nurse Practitioner | 2065 Woodlawn Dr, Conway, SC 29526-7703 | 2019-02-22 |
1679051668 | Mary Elizabeth Black | Nurse Practitioner | 222 Dave Ward Drive, Conway, AR 72032 | 2018-08-01 |
1780191015 | Sydnie Thessing | Nurse Practitioner | 605 Dave Ward Drive #105, Conway, AR 72034 | 2018-01-09 |
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.