NPIMap

Organization Active NPI

Conway Regional Medical Center Inc

  • General Acute Care Hospital
  • Conway, AR
National Provider Identifier
1497770424
Registry record updated Feb 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
2657 Issued in AR
Legal business name
CONWAY REGIONAL MEDICAL CENTER INC
Doing business as
Conway Regional Medical Center Inc
Practice address
2302 College Ave
Conway, AR 72034-6297
Phone
(501) 329-3831
Fax
(501) 450-2363
NPI assigned
Jul 12, 2006
Last updated
Feb 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2011

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

Authorized official

Name
Mr. Steve Rose
Title
Chief Financial Officer
Phone
(501) 450-2112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 2657 AR Primary

Addresses

Primary practice location

2302 College Ave
Conway, AR 72034-6297

Mailing address

2302 College Ave
Conway, AR 72034-6297
Phone (501) 329-3831

Other names 1

  • Conway Regional Medical Center Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071201000077 AR Part A Provider - Hospital 3173428414 5 other NPIs on this enrollment
Practice locations: Conway, AR; Vilonia, AR; Russellville, AR; Greenbrier, AR; Mayflower, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497770424. Details of each certification follow.

Hospital certification: CCN 040029

Legal name
CONWAY REGIONAL MEDICAL CENTER INC
Doing business as
CONWAY REGIONAL MEDICAL CENTER INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jun 25, 2021
Beds
150
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Sep 26, 1938 in AR
Enrollment address
2302 College Avenue
Conway, AR 72034-6297
Other Hospital Practice Location
Hospital subgroups
Acute care, Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Conway Regional Medical Center, IncCCN 040029 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Conway Reg Med Ctr Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

2125 Robinson Ave
Conway, AR 72034
Phone (501) 358-6700

2425 Dave Ward Dr
Ste 401
Conway, AR 72034
Phone (501) 329-3824

437 Denison St
#2
Conway, AR 72034

525 Western Ave
Conway, AR 72034
Phone (501) 213-5337

525 Western Ave
Ste 201
Conway, AR 72034
Phone (501) 327-1727

525 Western Ave
Ste 305
Conway, AR 72034
Phone (501) 358-6145

525 Western Ave
Ste 305B
Conway, AR 72034
Phone (501) 205-4990

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Allison Bramlett Individual W-2 Managing EmployeeDelegated Official Jan 1, 2024
Susan Gatto Individual Operational/Managerial ControlBoard Member Jan 1, 2022
Thaddeus Michael Stanton Individual Operational/Managerial ControlBoard Member Jan 1, 2024
William Pack Individual W-2 Managing EmployeeCfo Aug 29, 2022
Operational/Managerial ControlCfo Aug 29, 2022
Matthew Troup Individual Corporate OfficerPresident & Ceo Sep 14, 2015
Jeremy O Riddle Individual Operational/Managerial ControlBoard Member Jan 1, 2024
Thad R Hardin Individual Operational/Managerial ControlBoard Member Jan 1, 2017
Jeffrey Standridge Individual Operational/Managerial ControlBoard Member Jan 1, 2017
Tom Poe Individual Operational/Managerial ControlBoard Member Jan 1, 2013
Gena Ester Individual Operational/Managerial ControlBoard Member Jan 1, 2022
Andrew Cole Individual Operational/Managerial ControlBoard Member Jan 1, 2012
Wayne Cox Individual Operational/Managerial ControlBoard Member Jan 1, 2013
Bryan Bruich Individual Operational/Managerial ControlBoard Member Jan 1, 2022

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Conway Regional Rehabilitation Hospital LLCConway, AR, CCN 043033 Hospital 5% Or Greater Direct Ownership Interest (69.6%) Apr 6, 2004
Dardanelle Regional Medical CenterDardanelle, AR, CCN 04Z302 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2022
Dardanelle Regional Medical CenterDardanelle, AR, CCN 04M302 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2022
Dardanelle Regional Medical CenterDardanelle, AR, CCN 041302 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2022
Conway Regional Medical Clinic - ViloniaVilonia, AR, CCN 048536 Rural health clinic Operational/Managerial Control (100%) Dec 11, 2014
Greenbrier Family MedicineGreenbrier, AR, CCN 048534 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Oct 25, 2004
Oct 25, 2004
Mayflower Medical ClinicMayflower, AR, CCN 048537 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 25, 2004
Clinton Medical ClinicClinton, AR, CCN 048563 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 25, 2004

Practitioners & affiliated clinicians

Practitioners 133

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 133

Affiliated clinicians 490

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 490

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296518400000",
    "number": "1497770424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346297",
            "telephone_number": "501-329-3831",
            "fax_number": "501-450-2363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346297",
            "telephone_number": "501-329-3831",
            "fax_number": "501-450-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY REGIONAL MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-02-01",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "501-450-2112",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "AR",
            "license": "2657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conway Regional Medical Center Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.