Individual provider Active NPI

Robert Corey Paladino, NP-C

  • Family Nurse Practitioner
  • Conway, AR
National Provider Identifier
1366076010
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
123566 Issued in AR
Practice address
655 Dave Ward Dr
Conway, AR 72034-7083
Phone
(501) 209-4040
NPI assigned
Mar 2, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 123566 AR
Family Nurse Practitioner 363LF0000X 123566 AR Primary

Addresses

Primary practice location

655 Dave Ward Dr
Conway, AR 72034-7083

Mailing address

655 Dave Ward Dr
Conway, AR 72034-7083
Phone (501) 209-4040

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200320000475 AR Practitioner - Nurse Practitioner 6204264500 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians
Faulkner Emergency Group, PLLCGroup PAC ID 1557694049, 19 clinicians

Practice addresses (Care Compare)

1808 W Main St
Russellville, AR 72801-2724
Phone (501) 968-2841

2302 College Ave
Conway, AR 72034-6297
Phone (501) 329-3831

Hospital & facility affiliations

  • Conway Regional Medical Center, Inc Hospital, Conway, AR, CCN 040029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
123566ARMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Nurse Practitioner CurrentSince Oct 1, 2021 Accepting new patients
Faulkner Emergency Group, PLLC Nurse Practitioner CurrentSince Aug 15, 2022 Accepting new patients
Greenbrier Emergency Services, Inc. Nurse Practitioner CurrentSince Nov 15, 2023 Accepting new patients

Locations

1 Medical Park Dr
Bryant, AR 72015
Phone (501) 776-6000

2302 College Ave
Conway, AR 72034
Phone (501) 329-3831

1555 Exchange Ave
Conway, AR 72032
Phone (501) 202-2300

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

3333 Springhill Dr
North Little Rock, AR 72117
Phone (501) 202-3000

1808 W Main St
Russellville, AR 72801
Phone (479) 964-4178

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.

Hospital & facility affiliations 6

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": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1366076010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 DAVE WARD DR",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347083",
            "telephone_number": "501-209-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 DAVE WARD DR",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347083",
            "telephone_number": "501-209-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALADINO",
        "first_name": "ROBERT",
        "middle_name": "COREY",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-02",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "123566",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "123566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.