NPIMap

Individual provider Active NPI

Thad Ridge Hardin, M.D.

  • Family Medicine Physician
  • Conway, AR
National Provider Identifier
1326246190
Registry record updated Mar 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E5864 Issued in AR
Practice address
2425 Dave Ward Dr Ste 401
Conway, AR 72034
Phone
(501) 329-3824
NPI assigned
Jul 3, 2007
Last updated
Mar 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E5864 AR Primary

Addresses

Primary practice location

2425 Dave Ward Dr Ste 401
Conway, AR 72034

Mailing address

2425 Dave Ward Dr Ste 401
Conway, AR 72034-8681
Phone (501) 329-3824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090630000174 AR Practitioner - Family PracticePractitioner - Emergency Medicine 6507917721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bowlin-Cummins PAGroup PAC ID 5698725745, 8 clinicians

Practice addresses (Care Compare)

2425 Dave Ward Dr
Suite 401
Conway, AR 72034-8681
Phone (501) 329-3824

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.22 of 100Reported as group
Quality
93.45
Improvement activities
40
Cost
72.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E5864ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bowlin-Cummins PA Family Medicine CurrentSince Jul 1, 2010 Accepting new patients

Locations

2425 Dave Ward Dr
Ste 401
Conway, AR 72034
Phone (501) 329-3824

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Conway Regional Medical Center IncConway, AR, CCN 040029 Hospital Operational/Managerial Control Jan 1, 2017
Conway Regional Home Health ServicesConway, AR, CCN 047083 Home health agency Corporate Director Jan 1, 2017
Banister Lieblong ClinicConway, AR, CCN 043853 Rural health clinic 5% Or Greater Direct Ownership Interest (16.66%) Oct 1, 2024
Greenbrier Family MedicineGreenbrier, AR, CCN 048534 Rural health clinic Corporate Director (10%) Jun 29, 2022
Mayflower Medical ClinicMayflower, AR, CCN 048537 Rural health clinic Corporate Director (10%) Jan 1, 2017
Clinton Medical ClinicClinton, AR, CCN 048563 Rural health clinic Corporate Director (10%) Jan 1, 2017

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300060800000",
    "number": "1326246190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 DAVE WARD DR STE 401",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720348681",
            "telephone_number": "501-329-3824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 DAVE WARD DR STE 401",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "72034",
            "telephone_number": "501-329-3824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDIN",
        "first_name": "THAD",
        "middle_name": "RIDGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2011-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E5864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.