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Conway Regional Medical Center Inc

Organization Active NPI Home Health Agency · Conway, AR

NPI 1154340552 · NPPES record last updated Sep 4, 2024

Key facts

NPI
1154340552
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
License
4068 (AR)
Legal business name
CONWAY REGIONAL MEDICAL CENTER INC
Practice address
2843 Prince St
Conway, AR 72034-3637
Phone
(501) 329-9377
Fax
(501) 329-0724
NPI assigned
Jul 18, 2006
Organization subpart
Yes
Parent organization (as reported)
CONWAY REGIONAL MEDICAL CENTER INC

Authorized official

Name
William Pack
Title
Cfo
Phone
(501) 450-2112

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Corporate family (same tax ID) 14

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 2

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

Affiliated clinicians 38

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 38

Medicare Care Compare: Home health agency

Listed as
Conway Regional Homecare SVCS CCN 047083
Overall star rating
★★★★★ 4.5 of 5
Ownership
Proprietary
Certified
Mar 6, 1984
Medicare certification status
Active (Provider of Services file)
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AR

Home health agency certification: CCN 047083

Legal name
CONWAY REGIONAL MEDICAL CENTER INC
Doing business as
CONWAY REGIONAL HOME HEALTH SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 6, 1984
Last certification
Feb 7, 2019
Ownership / control type
Proprietary
Organization structure
Corporation · Non-profit
Enrollment address
2843 Prince Street
Conway, AR 72034-3637
HHA Branch

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Allison Bramlett
Individual 		W-2 Managing Employee
Credentialer		 Jul 18, 2023
Susan Gatto
Individual 		Corporate Director
Board Member		 Jan 1, 2022
Carter Dodd
Individual 		Corporate Director
Associate Administrator		 Apr 1, 2021
Jim Rankin
Individual 		Corporate Director
Board Member		 Jan 1, 2012
William Pack
Individual 		Corporate Director
Cfo		 Aug 29, 2022
W-2 Managing Employee
Cfo		 Aug 29, 2022
Matthew Troup
Individual 		Contracted Managing Employee
Ceo		 Sep 15, 2015
Operational/Managerial Control
Ceo		 Sep 15, 2015
Rebekah Fincher
Individual 		Corporate Director
Chief Administrative Officer		 Jan 1, 2023
W-2 Managing Employee
Chief Administrative Officer		 Jan 1, 2023
Thad R Hardin
Individual 		Corporate Director
Board Member		 Jan 1, 2017
Jeffrey Standridge
Individual 		Corporate Director
Board Member		 Jan 1, 2017
Tom Poe
Individual 		Corporate Director
Board Member		 Jan 1, 2013
Gena Ester
Individual 		Corporate Director
Board Member		 Jan 1, 2022
Andrew Cole
Individual 		Corporate Director
Board Member		 Jan 1, 2012
Wayne Cox
Individual 		Corporate Director
Board Member		 Jan 1, 2013
Sindee Morse
Individual 		Corporate Director Nov 20, 2022
Operational/Managerial Control Nov 20, 2022
Bryan Bruich
Individual 		Corporate Director
Board Member		 Jan 1, 2022

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Conway Regional Rehabilitation Hospital LLC
Conway, AR · CCN 043033		 Hospital 5% Or Greater Direct Ownership Interest (69.6%) Apr 6, 2004
Dardanelle Regional Medical Center
Dardanelle, AR · CCN 04Z302		 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2022
Dardanelle Regional Medical Center
Dardanelle, AR · CCN 04M302		 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2022
Dardanelle Regional Medical Center
Dardanelle, AR · CCN 041302		 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2022
Conway Regional Medical Clinic - Vilonia
Vilonia, AR · CCN 048536		 Rural health clinic Operational/Managerial Control (100%) Dec 11, 2014
Greenbrier Family Medicine
Greenbrier, AR · CCN 048534		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Oct 25, 2004
Oct 25, 2004
Mayflower Medical Clinic
Mayflower, AR · CCN 048537		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 25, 2004
Clinton Medical Clinic
Clinton, AR · CCN 048563		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 25, 2004

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20081024000631 AR Part a Provider - Home Health Agency 3173428414 Practice locations: Conway, AR

National Provider Directory

Tax ID family
Center Ridge Family Med (15 organizations share this tax ID)
Part of
Center Ridge Family Med

Locations

2843 Prince St
Conway, AR 72034
Phone (501) 329-9377

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 4068 AR Yes

Addresses

Primary practice location

2843 Prince St
Conway, AR 72034-3637

Mailing address

2843 Prince St
Conway, AR 72034-3637
Phone (501) 329-9377

Other identifiers

IdentifierTypeStateIssuer
102221514MedicaidAR
5000028OtherUNITED HEALTHCARE
047083OtherCOMMERCIAL INSURANCES
17083OtherBLUE CROSS

Other names

  • Conway Regional HomeCare Services Doing business as

Other providers in Conway, AR

All providers in Conway, AR · Home Health Agency in Arkansas

Sources for this page

Verify at the official NPI Registry.