NPIMap

Organization Active NPI

Noydeen Sisters Medical Group & Clinics, Inc

  • Internal Medicine Physician
  • Conway, AR
National Provider Identifier
1285084038
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NOYDEEN SISTERS MEDICAL GROUP & CLINICS, INC
Practice address
655 Dave Ward Dr Ste 103
Conway, AR 72034-7145
Phone
(501) 209-4040
Fax
(501) 205-1776
NPI assigned
Jun 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Authorized official

Name
Ahmed Ali, M.DNPI 1841425253
Title
Owner, Ceo
Phone
(501) 209-4040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

655 Dave Ward Dr Ste 103
Conway, AR 72034-7145

Mailing address

655 Dave Ward Dr Ste 103
Conway, AR 72034-7145
Phone (501) 209-4040

Other practice location 1

1605 W Main St
Russellville, AR 72801-2719
Phone (501) 209-4040

Other practice location 2

10319 W Markham St Ste 300
Little Rock, AR 72205-4556
Phone (501) 209-4040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160722000140 AR Part B Supplier - Clinic/Group Practice 7618260092 Receives reassigned benefits from 9 practitioners
Practice locations: Conway, AR; Little Rock, AR; Russellville, AR
O20170929000515 AR DME Supplier - Physician - Internal Medicine 7618260092 Practice locations: Conway, AR

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2118445Noydeen Sisters Medical Group and Clinics655 Dave Ward Dr Suite 103, Conway, AR 72034Certificate of waiverSep 7, 2026

National Provider Directory

National Provider Directory
Tax ID family
Noydeen Medical Group- Russellville4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

655 Dave Ward Dr
Conway, AR 72034
Phone (501) 209-4040

1609 W 40th Ave
Ste 403
Pine Bluff, AR 71603
Phone (870) 534-4188

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1285084038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 DAVE WARD DR STE 103",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347145",
            "telephone_number": "501-209-4040",
            "fax_number": "501-205-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 DAVE WARD DR STE 103",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347145",
            "telephone_number": "501-209-4040",
            "fax_number": "501-205-1776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1605 W Main St",
            "address_purpose": "LOCATION",
            "city": "Russellville",
            "state": "AR",
            "postal_code": "728012719",
            "country_code": "US",
            "telephone_number": "501-209-4040",
            "fax_number": "501-205-1776",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10319 W Markham St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722054556",
            "country_code": "US",
            "telephone_number": "501-209-4040",
            "fax_number": "501-205-1776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOYDEEN SISTERS MEDICAL GROUP & CLINICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-13",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "OWNER, CEO",
        "authorized_official_telephone_number": "501-209-4040",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "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 Jun 3, 2024; 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.