Organization Active NPI

Roy E Denton MD PA

  • Internal Medicine Physician
  • Conway, AR
National Provider Identifier
1093837619
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C7072 Issued in AR
Legal business name
ROY E DENTON MD PA
Practice address
2210 Robinson Ave
Conway, AR 72034-4943
Phone
(501) 932-3500
Fax
(501) 932-3520
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2018

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

Authorized official

Name
Neida Byrd
Title
Billiing Manager
Phone
(901) 737-3071

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X C7072 AR Primary

Addresses

Primary practice location

2210 Robinson Ave
Conway, AR 72034-4943

Mailing address

1138 N Germantown Pkwy # 101-377
Cordova, TN 38016-5872
Phone (901) 737-3071

Other identifiers 1

IdentifierTypeStateIssuer
116106001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101008000989 AR Part B Supplier - Clinic/Group Practice 7214129238 Receives reassigned benefits from 1 practitioner
Practice locations: Conway, AR

National Provider Directory

National Provider Directory

Locations

2513 McCain Blvd
#2377
North Little Rock, AR 72116

228 W Tyler Ave
Ste 107
West Memphis, AR 72301
Phone (870) 735-0073

Practitioners & affiliated clinicians

Practitioners 3

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": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519171200000",
    "number": "1093837619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 N GERMANTOWN PKWY # 101-377",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380165872",
            "telephone_number": "901-737-3071",
            "fax_number": "901-328-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 ROBINSON AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344943",
            "telephone_number": "501-932-3500",
            "fax_number": "501-932-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROY E DENTON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2018-02-21",
        "status": "A",
        "authorized_official_last_name": "BYRD",
        "authorized_official_first_name": "NEIDA",
        "authorized_official_title_or_position": "BILLIING MANAGER",
        "authorized_official_telephone_number": "901-737-3071"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "C7072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116106001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "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 Feb 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.