NPIMap

Organization Active NPI

Conway Medical and Wellness Clinic, LLC

  • Health Service Clinic/Center
  • Conway, AR
National Provider Identifier
1033822960
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
CONWAY MEDICAL AND WELLNESS CLINIC, LLC
Practice address
805 Monroe St Ste 104
Conway, AR 72032-5642
Phone
(501) 932-6070
NPI assigned
Jan 5, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sharonte Lambert Fowler, APRNNPI 1457801342
Title
Owner/Aprn
Phone
(501) 733-6124

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

805 Monroe St Ste 104
Conway, AR 72032-5642

Mailing address

118 Eagle Ridge Dr
Maumelle, AR 72113-7649
Phone (501) 733-6124

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL na Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1672876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672876800000",
    "number": "1033822960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 EAGLE RIDGE DR",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721137649",
            "telephone_number": "501-733-6124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 MONROE ST STE 104",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325642",
            "telephone_number": "501-932-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY MEDICAL AND WELLNESS CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A",
        "authorized_official_last_name": "LAMBERT FOWLER",
        "authorized_official_first_name": "SHARONTE",
        "authorized_official_title_or_position": "OWNER/APRN",
        "authorized_official_telephone_number": "501-733-6124",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "na",
            "affiliation": "N",
            "endpointDescription": "na",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "805 Monroe St Ste 104",
            "city": "Conway",
            "state": "AR",
            "country_code": "US",
            "postal_code": "720325642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.