Individual provider Active NPI

Carly Roark Hutchison, M.D.

  • Pediatrics Physician
  • Conway, AR
National Provider Identifier
1316478845
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
E-13303 Issued in AR
Practice address
625 United Dr Ste 410
Conway, AR 72032-7816
Phone
(501) 358-6892
Fax
(501) 358-6894
NPI assigned
Mar 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X E-13303 AR Primary

Addresses

Primary practice location

625 United Dr Ste 410
Conway, AR 72032-7816

Mailing address

625 United Dr Ste 410
Conway, AR 72032-7816
Phone (501) 358-6892

Other names 1

  • Carly Alexis Roark Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200710000292 AR Practitioner - Pediatric Medicine 2860760915 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group CurrentSince Aug 3, 2020 Accepting new patients
Arkansas Health Group CurrentSince Aug 3, 2020 Accepting new patients
Arkansas Health Group Past Accepting new patients

Locations

625 United Dr
Ste 360
Conway, AR 72032
Phone (501) 358-6206

625 United Dr
Ste 410
Conway, AR 72032
Phone (501) 358-6892

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

Interoperability endpoints

  • Direct secure messaging: croark449700@direct.baptist-healthar.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1490486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1316478845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 UNITED DR STE 410",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720327816",
            "telephone_number": "501-358-6892",
            "fax_number": "501-358-6894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 UNITED DR STE 410",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720327816",
            "telephone_number": "501-358-6892",
            "fax_number": "501-358-6894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHISON",
        "first_name": "CARLY",
        "middle_name": "ROARK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-26",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-13303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "ROARK",
            "middle_name": "ALEXIS",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.