Organization Active NPI

Conway Pulmonology Clinic, PA

  • Pulmonary Disease Physician
  • Conway, AR
National Provider Identifier
1215954086
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
C8126 Issued in AR
Legal business name
CONWAY PULMONOLOGY CLINIC, PA
Practice address
3700 College Ave
Conway, AR 72034-7259
Phone
(501) 327-9532
Fax
(501) 327-9562
NPI assigned
Jul 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ashley Hoelzeman
Title
Manager
Phone
(501) 327-9532

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X C8126 AR Primary

Addresses

Primary practice location

3700 College Ave
Conway, AR 72034-7259

Mailing address

3700 College Ave
Conway, AR 72034-7259
Phone (501) 327-9532

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081006000716 AR Part B Supplier - Clinic/Group Practice 9032287891 Receives reassigned benefits from 1 practitioner
Practice locations: Conway, AR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215954086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347259",
            "telephone_number": "501-327-9532",
            "fax_number": "501-327-9562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347259",
            "telephone_number": "501-327-9532",
            "fax_number": "501-327-9562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY PULMONOLOGY CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOELZEMAN",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "501-327-9532"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AR",
            "license": "C8126",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 22, 2020; 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.