NPIMap

Organization Active NPI

Triad Eye Institute PLLC

  • Ophthalmology Physician
  • Fayetteville, AR
National Provider Identifier
1619702735
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
TRIAD EYE INSTITUTE PLLC
Practice address
2783 N Shiloh Dr
Fayetteville, AR 72704-6983
Phone
(479) 442-8653
NPI assigned
Sep 6, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Authorized official

Name
Ryan Patrick Conley, DO
Title
Manager
Phone
(918) 252-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

2783 N Shiloh Dr
Fayetteville, AR 72704-6983

Mailing address

6140 S Memorial Dr
Tulsa, OK 74133-1933
Phone (918) 252-2020

Other practice location 1

1102 NW Lowes Ave Ste 6
Bentonville, AR 72712-4978
Phone (479) 442-8653

National Provider Directory

National Provider Directory
Tax ID family
Triad Eye Institute PLLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

1101 NW Lowes Ave Ste 6
Bentonville, AR 72712

NPI Registry JSON

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

{
    "created_epoch": "1725580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1619702735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 S MEMORIAL DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741331933",
            "telephone_number": "918-252-2020",
            "fax_number": "918-307-1983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2783 N SHILOH DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046983",
            "telephone_number": "479-442-8653"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1102 NW Lowes Ave Ste 6",
            "address_purpose": "LOCATION",
            "city": "Bentonville",
            "state": "AR",
            "postal_code": "727124978",
            "country_code": "US",
            "telephone_number": "479-442-8653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRIAD EYE INSTITUTE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-06",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A",
        "authorized_official_last_name": "CONLEY",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "918-252-2020",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.