NPIMap

Organization Active NPI

Amanda Bledsoe Chiropractic Center, PLLC

Doing business as Bledsoe Chiropractic

  • Chiropractor
  • Conway, AR
National Provider Identifier
1295247294
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
AMANDA BLEDSOE CHIROPRACTIC CENTER, PLLC
Doing business as
Bledsoe Chiropractic
Practice address
775 Amity Rd
Conway, AR 72032-5991
Phone
(501) 504-6999
Fax
(501) 205-8431
NPI assigned
Oct 30, 2017
Last updated
Oct 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Authorized official

Name
Ashlyn Marie Osborne
Title
Front Desk Manager
Phone
(501) 504-6999

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

775 Amity Rd
Conway, AR 72032-5991

Mailing address

775 Amity Rd
Conway, AR 72032-5991
Phone (501) 504-6999

Other practice location 1

9772 Maumelle Blvd
North Little Rock, AR 72113-6737
Phone (501) 975-5432

Other names 1

  • Bledsoe Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171220003198 AR Part B Supplier - Clinic/Group Practice 9830457829 Receives reassigned benefits from 7 practitioners
Practice locations: Conway, AR; North Little Rock, AR

National Provider Directory

National Provider Directory

Locations

1155 Front St
Ste 1
Conway, AR 72032
Phone (501) 327-6672

9772 Maumelle Blvd
North Little Rock, AR 72113
Phone (501) 725-5432

Practitioners & affiliated clinicians

Practitioners 9

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": "1509321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698019200000",
    "number": "1295247294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 AMITY RD",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325991",
            "telephone_number": "501-504-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 AMITY RD",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325991",
            "telephone_number": "501-504-6999",
            "fax_number": "501-205-8431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9772 Maumelle Blvd",
            "address_purpose": "LOCATION",
            "city": "North Little Rock",
            "state": "AR",
            "postal_code": "721136737",
            "country_code": "US",
            "telephone_number": "501-975-5432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AMANDA BLEDSOE CHIROPRACTIC CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-30",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A",
        "authorized_official_last_name": "OSBORNE",
        "authorized_official_first_name": "ASHLYN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "FRONT DESK MANAGER",
        "authorized_official_telephone_number": "501-504-6999"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bledsoe Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 23, 2023; 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.