NPIMap

Individual provider Active NPI

Timothy E Freyaldenhoven, MD

  • Neurology Physician
  • Conway, AR
National Provider Identifier
1174520258
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
E-3108 Issued in AR
Practice address
2200 Ada Ave Ste 302
Conway, AR 72034-4985
Phone
(501) 932-0352
Fax
(501) 932-0354
NPI assigned
Jul 5, 2005
Last updated
Mar 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X E-3108 AR Primary

Addresses

Primary practice location

2200 Ada Ave Ste 302
Conway, AR 72034-4985

Mailing address

2200 Ada Ave Ste 302
Conway, AR 72034-4985
Phone (501) 932-0352

Other identifiers 2

IdentifierTypeStateIssuer
146351001MedicaidAR
130025088OtherARMEDICARE RAILROAD

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
I20100306000331 AR Practitioner - Neurology 2961464946 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Arkansas College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1701 S Shackleford Rd
Little Rock, AR 72211-4335
Phone (501) 219-7000

2200 Ada Ave
Suite 302
Conway, AR 72034-4985
Phone (501) 932-0352

9305 Treasure Hill Rd
Little Rock, AR 72227-6217
Phone (877) 989-9919

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-3108ARMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Regional Medical Center Inc CurrentSince Feb 20, 2017 Accepting new patients
Sleep Centers of Arkansas - Searcy LLC CurrentSince Jan 15, 2019 Accepting new patients
Conway Regional Medical Center, Inc. Neurology CurrentSince Feb 20, 2017 Accepting new patients
Conway Regional Medical Center Inc Past Accepting new patients

Locations

2200 Ada Ave
Ste 302
Conway, AR 72034
Phone (501) 932-0352

2200 Ada Ave
Ste 305
Conway, AR 72034
Phone (501) 227-6044

306 E Market Ave
Searcy, AR 72143
Phone (501) 207-1553

Interoperability endpoints

  • Direct secure messaging: freyaldenhoven.timothy.001.0040006@crnc.meditab.direct-ci.com
  • Direct secure messaging: freyaldenhoven.timothy.015.0040006@crnc.meditab.direct-ci.com

Organizations & group practices 5

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

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1174520258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 ADA AVE STE 302",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344985",
            "telephone_number": "501-932-0352",
            "fax_number": "501-932-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 ADA AVE STE 302",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344985",
            "telephone_number": "501-932-0352",
            "fax_number": "501-932-0354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREYALDENHOVEN",
        "first_name": "TIMOTHY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AR",
            "license": "E-3108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146351001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "130025088",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.