NPIMap

Organization Active NPI

William L. McColgan, III, M.D., PA

  • Surgery Physician
  • Conway, AR
National Provider Identifier
1306072269
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
E-5948 Issued in AR
Legal business name
WILLIAM L. MCCOLGAN, III, M.D., PA
Doing business as
William L. McColgan III, MD, PA
Practice address
2425 Dave Ward Dr Ste 201
Conway, AR 72034-8680
Phone
(501) 504-2737
Fax
(501) 504-2798
NPI assigned
Jun 5, 2009
Last updated
Jun 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Authorized official

Name
Dr. William Lewis McColgan III, M.D.NPI 1487848545
Title
Owner
Phone
(501) 504-2737

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
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X E-5948 AR Primary

Addresses

Primary practice location

2425 Dave Ward Dr Ste 201
Conway, AR 72034-8680

Mailing address

2425 Dave Ward Dr Ste 201
Conway, AR 72034-8680
Phone (501) 504-2737

Other names 1

  • William L. McColgan III, MD, PA Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lew.mccolgan@msc.directbygreenway.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090701000211 AR Part B Supplier - Clinic/Group Practice 6002967197 Receives reassigned benefits from 1 practitioner
Practice locations: Little Rock, AR; Conway, AR

National Provider Directory

National Provider Directory

Locations

10915 N Rodney Parham Rd
Little Rock, AR 72212
Phone (501) 747-2828

10915 N Rodney Parham Rd
Ste B
Little Rock, AR 72212
Phone (501) 747-2828

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73349
  • Direct secure messaging: lew.mccolgan@msc.directbygreenway.com

Practitioners & affiliated clinicians

Practitioners 11

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": "1244160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591142400000",
    "number": "1306072269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 DAVE WARD DR STE 201",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720348680",
            "telephone_number": "501-504-2737",
            "fax_number": "501-504-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 DAVE WARD DR STE 201",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720348680",
            "telephone_number": "501-504-2737",
            "fax_number": "501-504-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM L. MCCOLGAN, III, M.D., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-05",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A",
        "authorized_official_last_name": "MCCOLGAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "LEWIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-504-2737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "AR",
            "license": "E-5948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lew.mccolgan@msc.directbygreenway.com",
            "affiliation": "N",
            "address_1": "2425 Dave Ward Dr Ste 201",
            "city": "Conway",
            "state": "AR",
            "country_code": "US",
            "postal_code": "720348680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "William L. McColgan III, MD, PA",
            "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 Jun 3, 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.