NPIMap

Organization Active NPI

Arkansas Allergy & Asthma Clinic, P.a.

  • Allergy & Immunology Physician
  • Conway, AR
National Provider Identifier
1609837459
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
ARKANSAS ALLERGY & ASTHMA CLINIC, P.A.
Practice address
400 Salem Rd
Suite 4
Conway, AR 72034-6162
Phone
(501) 329-0237
Fax
(501) 932-0565
NPI assigned
Mar 31, 2006
Last updated
Jul 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Authorized official

Name
Mary Prince
Title
Administrator
Phone
(501) 329-0237

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X NU Primary

Addresses

Primary practice location

400 Salem Rd
Suite 4
Conway, AR 72034-6162

Mailing address

400 Salem Rd
Suite 4
Conway, AR 72034-6162
Phone (501) 329-0237

Other identifiers 1

IdentifierTypeStateIssuer
104277002MedicaidAR

National Provider Directory

National Provider Directory
Tax ID family
Arkansas Allergy Asthma Clinic PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

400 Salem Rd
Ste 4
Conway, AR 72034
Phone (501) 327-2235

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1609837459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SALEM RD",
            "address_2": "SUITE 4",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346162",
            "telephone_number": "501-329-0237",
            "fax_number": "501-932-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SALEM RD",
            "address_2": "SUITE 4",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346162",
            "telephone_number": "501-329-0237",
            "fax_number": "501-932-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS ALLERGY & ASTHMA CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "501-329-0237"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104277002",
            "state": "AR"
        }
    ],
    "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 Jul 14, 2008; 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.