Condrey Pediatric Clinic

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

CONDREY PEDIATRIC CLINIC

Practice address

4 Medical PLZ
Mountain Home, AR 72653-2919

Phone

(870) 425-6272

Fax

(870) 424-3320

NPI assigned

Jun 2, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Carol Vaughn

Title

Practice Manager

Phone

(870) 425-6272

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1427284694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MEDICAL PLZ",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532919",
            "telephone_number": "870-425-6272",
            "fax_number": "870-424-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MEDICAL PLZ",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532919",
            "telephone_number": "870-425-6272",
            "fax_number": "870-424-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONDREY PEDIATRIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-02",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "870-425-6272",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• Pediatrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.