NPIMap

Organization Active NPI

Conway Regional Medical Center Inc

Doing business as Conway Regional Cardiovascular Clinic

  • Cardiovascular Disease Physician
  • Conway, AR
National Provider Identifier
1639624372
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CONWAY REGIONAL MEDICAL CENTER INC
Doing business as
Conway Regional Cardiovascular Clinic
Practice address
525 Western Ave
Suite 202
Conway, AR 72034-4967
Phone
(501) 513-5337
Fax
(501) 513-5338
NPI assigned
Aug 23, 2016
Last updated
Jun 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Authorized official

Name
Matthew Troup
Title
Ceo/President
Phone
(501) 450-2111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

525 Western Ave
Suite 202
Conway, AR 72034-4967

Mailing address

PO Box 9662
Conway, AR 72033-9662
Phone (501) 852-1363

Other names 1

  • Conway Regional Cardiovascular Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161014001291 AR Part B Supplier - Clinic/Group Practice 3173428414 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: Conway, AR; Dardanelle, AR; Greenbrier, AR; Mayflower, AR; Russellville, AR; Vilonia, AR

Other NPIs on the same Medicare enrollment 1

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

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

525 Western Ave
Ste 2
Conway, AR 72034
Phone (501) 358-6905

Ownership & related parties

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 11

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": "1471910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1639624372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9662",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720339662",
            "telephone_number": "501-852-1363",
            "fax_number": "501-852-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 WESTERN AVE",
            "address_2": "SUITE 202",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344967",
            "telephone_number": "501-513-5337",
            "fax_number": "501-513-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY REGIONAL MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-23",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "TROUP",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "501-450-2111"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conway Regional Cardiovascular Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Conway Regional Cardiovascular Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.