Conway OB-GYN Clinic PA

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

CONWAY OB-GYN CLINIC PA

Practice address

2180 Ada Avenue
Suite 300
Conway, AR 72034-6135

Phone

(501) 327-6547

Fax

(501) 327-9715

NPI assigned

Mar 21, 2006

Organization subpart

No

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

Authorized official

Name

Robin Carol Fagala

Title

Practice Manager

Phone

(501) 327-6547

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1426
• FHIR API: https://fhir4.healow.com/fhir/r4/CFIBDD

Practitioners 9

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

• Kathryn S Boyd, APN

  • Family Nurse Practitioner
  • Conway, AR
  • NPI 1265514368
  Medicare reassignment Care Compare group NPD
• Andrew Axley Cole, MD

  • Obstetrics & Gynecology Physician
  • Conway, AR
  • NPI 1336111665
  Medicare reassignment Care Compare group NPD
• Phillip Thomas Gullic, MD

  • Obstetrics & Gynecology Physician
  • Conway, AR
  • NPI 1285606020
  Medicare reassignment Care Compare group NPD
• Keitha Dewitt Holland, MD

  • Obstetrics & Gynecology Physician
  • Conway, AR
  • NPI 1013988609
  Medicare reassignment Care Compare group NPD
• Megan Leigh Moix, NP-C

  • Family Nurse Practitioner
  • Conway, AR
  • NPI 1144738725

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Lauren Nolen, M.D.

  • Obstetrics & Gynecology Physician
  • Conway, AR
  • NPI 1124387238
  Medicare reassignment Care Compare group NPD
• Kassie Olivia Robertson, APN

  • Family Nurse Practitioner
  • Conway, AR
  • NPI 1811635634
  Medicare reassignment Care Compare group NPD
• Alexander Michael Smith, MD

  • Obstetrics & Gynecology Physician
  • Conway, AR
  • NPI 1487233177
  Medicare reassignment Care Compare group NPD
• Lisa Jeanette Speer, APRN

  • Family Nurse Practitioner
  • Conway, AR
  • NPI 1609466473
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604448000000",
    "number": "1235198045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 ADA AVENUE",
            "address_2": "SUITE 300",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346135",
            "telephone_number": "501-327-6547",
            "fax_number": "501-327-9715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 ADA AVENUE",
            "address_2": "SUITE 300",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346135",
            "telephone_number": "501-327-6547",
            "fax_number": "501-327-9715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY OB-GYN CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "FAGALA",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "501-327-6547"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115352002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Conway Marriage Clinic
• Conway Medcare Pharmacy, LLC
• Conway Medcare Pharmacy, LLC
• Conway Medical and Wellness Clinic, LLC
• Conway Neurology PA
• Conway Optometry Associates PLLC
• Conway Outpatient Surgery Center
• Conway Pain Clinic, PLLC
• Conway Physical Therapy Clinic, PA
• Conway Psychiatric Clinic, PLLC

• Obstetrics & Gynecology Physician in Conway, AR
• Providers in Conway, AR by specialty
• Obstetrics & Gynecology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.