Medgen Neuro

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

MEDGEN NEURO

Practice address

824 N Creek Dr
Conway, AR 72032-4711

Phone

(999) 999-9999

NPI assigned

Dec 15, 2021

Organization subpart

No

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

Authorized official

Name

Deanne Goss

Title

Managing Member

Phone

(999) 999-9999

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1487313557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 N CREEK DR",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324711",
            "telephone_number": "999-999-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 N CREEK DR",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324711",
            "telephone_number": "999-999-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDGEN NEURO",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-15",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A",
        "authorized_official_last_name": "GOSS",
        "authorized_official_first_name": "DEANNE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "999-999-9999"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meredith McWilliams, RD, LD, CSP
• Zoe Lynne Meacham
• Mandi Lyn Mears, APRN
• Mark N Meaux, CRNA
• Medexpress Urgent Care Arkansas, P.a.
• Medic Rental Inc
• Medical Park Primary Care, LLC
• Stefanie Gardner Meek, D.D.S.
• Kelley Courtney Meena, M.D.
• Carolyn Elaine Mehaffey, M.D.

• Physiological Laboratory in Conway, AR
• Providers in Conway, AR by specialty
• Physiological Laboratory in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.