Individual provider Active NPI

Annie Rose Conway, APRN

  • Family Nurse Practitioner
  • Fort Smith, AR
National Provider Identifier
1477209401
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
TEMP219160 Issued in AR
Practice address
9001 Jenny Lind Rd Ste 3
Fort Smith, AR 72908-8629
Phone
(479) 385-9001
Fax
(479) 289-5441
NPI assigned
Feb 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X TEMP219160 AR Primary

Addresses

Primary practice location

9001 Jenny Lind Rd Ste 3
Fort Smith, AR 72908-8629

Mailing address

9001 Jenny Lind Rd Ste 3
Fort Smith, AR 72908-8629
Phone (479) 385-9001

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
I20220316000218 AR Practitioner - Nurse Practitioner 3274928965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joseph E Miller MD PAGroup PAC ID 1052683901, 2 clinicians

Practice addresses (Care Compare)

9001 Jenny Lind Rd
Suite 3
Fort Smith, AR 72908-8629
Phone (479) 385-9001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TEMP219160ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fianna Hills Surgery Center Inc PastSince Feb 7, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: annie.conway@3100.securemail.prognocis.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1477209401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9001 JENNY LIND RD STE 3",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729088629",
            "telephone_number": "479-385-9001",
            "fax_number": "479-289-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 JENNY LIND RD STE 3",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729088629",
            "telephone_number": "479-385-9001",
            "fax_number": "479-289-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "ANNIE",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "TEMP219160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.