Active NPI
Ronald J Pelz, PSYD
- Clinical Child & Adolescent Psychologist
- Conway, AR
National Provider Identifier
1538253059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 05-07P
- Practice address
- 835 Faulkner Street
Conway, AR 72034 - Phone
- (501) 932-8558
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 05-07P | AR | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 05-07P | AR | Primary |
Addresses
Primary practice location
835 Faulkner Street
Conway, AR 72034
Mailing address
835 Faulkner Street
Conway, AR 72034
Phone (870) 613-2776
Other practice location 1
815 S Donaghey Ave
Conway, AR 72034-6880
Phone (501) 400-0924
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05-07P | AR | MD | Clinical Child & Adolescent Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alternative Oppurtunities | Past | Accepting new patients | |
| Integrative Counseling Solutions Inc. | Past | Accepting new patients | |
| Iowa River Hospice Inc | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Health Resources of Arkansas
- Case Management Agency
- Batesville, AR
- NPI 1720063779
-
dba Central Iowa Psychological Services
- Community/Behavioral Health Agency
- West Des Moines, IA
- NPI 1942437231
-
- Exclusive Provider Organization
- Marshalltown, IA
- NPI 1396731535
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672963200000",
"number": "1538253059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "835 FAULKNER STREET",
"city": "CONWAY",
"state": "AR",
"postal_code": "72034",
"telephone_number": "870-613-2776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 FAULKNER STREET",
"city": "CONWAY",
"state": "AR",
"postal_code": "72034",
"telephone_number": "501-932-8558"
}
],
"practiceLocations": [
{
"address_1": "815 S Donaghey Ave",
"address_purpose": "LOCATION",
"city": "Conway",
"state": "AR",
"postal_code": "720346880",
"country_code": "US",
"telephone_number": "501-400-0924",
"fax_number": "317-520-8200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PELZ",
"first_name": "RONALD",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2023-01-06",
"certification_date": "2023-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AR",
"license": "05-07P",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "AR",
"license": "05-07P",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.