Individual provider Active NPI

Arielle Holloway, NURSE PRACTITIONER

  • Nurse Practitioner
  • Conway, AR
National Provider Identifier
1487221537
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
216223 Issued in AR
Practice address
655 Dave Ward Dr Ste 103
Conway, AR 72034-7145
Phone
(501) 209-4040
Fax
(501) 205-1776
NPI assigned
Jun 8, 2021
Last updated
Nov 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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 216223 AR Primary
Registered Nurse 163W00000X R104399 AR

Addresses

Primary practice location

655 Dave Ward Dr Ste 103
Conway, AR 72034-7145

Mailing address

655 Dave Ward Dr Ste 103
Conway, AR 72034-7145
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
I20210712002574 AR Practitioner - Nurse Practitioner 4486056538 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
Noydeen Sisters Medical Group and Clinics IncGroup PAC ID 7618260092, 9 clinicians

Practice addresses (Care Compare)

1605 W Main St
Russellville, AR 72801-2719
Phone (501) 209-4040

655 Dave Ward Dr
Suite 103
Conway, AR 72034-7145
Phone (501) 209-4040

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R104399ARMDRegistered Nurse
216223ARMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Noydeen Sisters Medical Group & Clinics, Inc CurrentSince Jun 1, 2022 Accepting new patients

Locations

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

655 Dave Ward Dr
Ste 103
Conway, AR 72034
Phone (501) 209-4040

1100 N University Ave
Ste 200
Little Rock, AR 72207
Phone (501) 209-4040

1605 W Main St
Russellville, AR 72801
Phone (479) 219-5008

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 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": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1487221537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 DAVE WARD DR STE 103",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347145",
            "telephone_number": "501-209-4040",
            "fax_number": "501-205-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 DAVE WARD DR STE 103",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347145",
            "telephone_number": "501-209-4040",
            "fax_number": "501-205-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "ARIELLE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "216223",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R104399",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.