NPIMap

Individual provider Active NPI

Jordan Matthew Walters

  • Orthopaedic Surgery Physician
  • Conway, AR
National Provider Identifier
1124472410
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
E-14425 Issued in AR
Practice address
550 Club LN Ste 1
Conway, AR 72034-3681
Phone
(501) 329-1510
Fax
(501) 513-0478
NPI assigned
Apr 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X E-14425 AR Primary

Addresses

Primary practice location

550 Club LN Ste 1
Conway, AR 72034-3681

Mailing address

PO Box 9662
Conway, AR 72033-9662
Phone (501) 852-1363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210901001649 AR Practitioner - Orthopedic Surgery 7810280526 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Arkansas College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fands Physical Therapy, IncGroup PAC ID 7810898459, 217 clinicians
Conway Regional Medical Center IncGroup PAC ID 3173428414, 129 clinicians

Practice addresses (Care Compare)

1414 Hwy 71 N
Alma, AR 72921-4723
Phone (479) 632-0321

550 Club LN
Suite 1
Conway, AR 72034-3681
Phone (501) 329-1510

Hospital & facility affiliations

  • Conway Regional Medical Center, Inc Hospital, Conway, AR, CCN 040029
  • Ozark Health Hospital, Clinton, AR, CCN 041313

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion104
Laminectomy or laminotomy (partial removal of spine bones)32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Orthopaedic Surgery Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Aug 1, 2021 Accepting new patients
Arkansas Childrens Hospital CurrentSince Aug 1, 2021 Accepting new patients
Conway Regional Medical Center Inc CurrentSince Jun 1, 2025 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Aug 1, 2021 Accepting new patients
Arkansas Children'S Hospital CurrentSince Aug 1, 2021 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Aug 1, 2021 Accepting new patients
Conway Regional Medical Center Inc. Orthopaedic Surgery CurrentSince Jun 1, 2025 Accepting new patients
Conway Regional Medical Center Inc Past Accepting new patients

Locations

550 Club Ln
Ste 1
Conway, AR 72034
Phone (501) 329-1510

4301 W Markham St
#531
Little Rock, AR 72205
Phone (501) 686-5259

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

10815 Colonel Glenn Rd
Ste 500
Little Rock, AR 72204
Phone (501) 406-9201

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1124472410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9662",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720339662",
            "telephone_number": "501-852-1363",
            "fax_number": "501-852-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 CLUB LN STE 1",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343681",
            "telephone_number": "501-329-1510",
            "fax_number": "501-513-0478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "JORDAN",
        "middle_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-22",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AR",
            "license": "E-14425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.