Conway Endoscopy Center, Inc.

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

License

AR3956 Issued in AR

Legal business name

CONWAY ENDOSCOPY CENTER, INC.

Practice address

455 Hogan LN
Conway, AR 72034-8201

Phone

(501) 764-1960

Fax

(501) 513-0798

NPI assigned

Jun 30, 2005

Organization subpart

No

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

Authorized official

Name

Kevin D Heath, MDNPI 1992702336

Title

President

Phone

(501) 764-1960

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Listed as

Conway Endoscopy Center IncCCN 04C0001049

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Practitioners 4

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

• Kevin David Heath, MD

  • Gastroenterology Physician
  • Conway, AR
  • NPI 1992702336
  NPD (past) Authorized official
• Frank Martin Moix Jr., MD

  • Gastroenterology Physician
  • Conway, AR
  • NPI 1518950823
  NPD (past)
• Jeffrey D Robertson, MD

  • Gastroenterology Physician
  • Little Rock, AR
  • NPI 1366709404
  NPD (past)
• Joy Deane Wilcox, APN

  • Family Nurse Practitioner
  • Little Rock, AR
  • NPI 1962635359
  NPD (past)

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343779200000",
    "number": "1265439632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10780",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720340013",
            "telephone_number": "501-764-1960",
            "fax_number": "501-513-0798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 HOGAN LN",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720348201",
            "telephone_number": "501-764-1960",
            "fax_number": "501-513-0798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY ENDOSCOPY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2012-08-01",
        "status": "A",
        "authorized_official_last_name": "HEATH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-764-1960",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "AR",
            "license": "AR3956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145383128",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Conway County Community Service Inc.
• Conway Dental Center PLLC
• Conway Digestive Health Center, Inc.
• Conway Emergency Physicians, P.a.
• Conway Emergency Physicians, P.a.
• Conway Eye Center
• Conway Family Medical Care PA
• Conway Gastroenterology, PA
• Conway Group, P.L.L.C
• Conway Heart Clinic PLLC

• Endoscopy Clinic/Center in Conway, AR
• Providers in Conway, AR by specialty
• Endoscopy Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; 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.