Arkansas Pediatrics of Conway, PA
Organization Active NPI Pediatrics Physician · Conway, AR
NPI 1477516417 · NPPES record last updated Oct 7, 2021
Key facts
- NPI
- 1477516417
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MC1605 (AR)
- Legal business name
- ARKANSAS PEDIATRICS OF CONWAY, PA
- Practice address
- 2710 College Ave
Conway, AR 72034-6141 - Phone
- (501) 329-1800
- Fax
- (501) 329-2507
- NPI assigned
- Apr 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Donna M. Strickland
- Title
- Office Manager
- Phone
- (501) 329-1800
Practitioners 10
-
Bonnie Anderson, APRN
-
Karen F Baker, M.D.
-
Alexis Cooper, APRN
-
Betsy Anna Efird, APN
-
Philip H Hopp, M.D.
-
Deborah Jackson, A.P.N.
-
Reginald Alan Lucas, M.D.
-
Karen Louise Martin, A.P.N.
-
Steven D McNabb, MD
-
Emily Rougeau, APRN
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D0913091 | Arkansas Pediatrics of Conway | Compliance | Aug 20, 2026 |
National Provider Directory
Locations
2710 College Ave
Conway, AR 72034
Phone (501) 329-1800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | MC1605 | AR | Yes |
Addresses
Primary practice location
2710 College Ave
Conway, AR 72034-6141
Mailing address
PO Box 1210
Conway, AR 72033-1210
Phone (501) 329-1800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 127536002 | Medicaid | AR |
NPI Registry JSON
{
"created_epoch": "1144627200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1633564800000",
"number": "1477516417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1210",
"city": "CONWAY",
"state": "AR",
"postal_code": "720331210",
"telephone_number": "501-329-1800",
"fax_number": "501-329-2507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2710 COLLEGE AVE",
"city": "CONWAY",
"state": "AR",
"postal_code": "720346141",
"telephone_number": "501-329-1800",
"fax_number": "501-329-2507"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ARKANSAS PEDIATRICS OF CONWAY, PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-10",
"last_updated": "2021-10-07",
"certification_date": "2021-10-07",
"status": "A",
"authorized_official_last_name": "STRICKLAND",
"authorized_official_first_name": "DONNA",
"authorized_official_middle_name": "M.",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "501-329-1800",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "AR",
"license": "MC1605",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "127536002",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
- Arkansas Homecare Holdings, Inc.
- Arkansas Infusion Center
- Arkansas Neurology, Inc.
- Arkansas Oral Surgery
- Arkansas Oral Surgery
- Arkansas Renal Systems, Inc.
- Arkansas Surgical Hospital, LLC
- Arkansas Surgical Hospital, LLC
- Arkansas Urology, P.a.
- Arkansas Vein Care Clinics PLLC
All providers in Conway, AR · Pediatrics Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.