NPIMap

Organization Active NPI

Central Arkansas Pediatrics, P.a.

  • Pediatrics Physician
  • Conway, AR
National Provider Identifier
1659332849
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MC-1956 Issued in AR
Legal business name
CENTRAL ARKANSAS PEDIATRICS, P.A.
Practice address
3010 Fountain Drive
Conway, AR 72034-3684
Phone
(501) 328-0055
Fax
(501) 328-2194
NPI assigned
Mar 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Authorized official

Name
Jeffrey A Craig, M.D.NPI 1215915608
Title
Physician
Phone
(501) 328-0055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X MC-1956 AR Primary

Addresses

Primary practice location

3010 Fountain Drive
Conway, AR 72034-3684

Mailing address

3010 Fountain Drive
Conway, AR 72034-3684
Phone (501) 328-0055

Other identifiers 2

IdentifierTypeStateIssuer
5C289OtherARBLUE CROSS ID
139031002MedicaidAR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D1031708Central Arkansas Pediatrics3010 Fountain Drive, Conway, AR 72034Certificate of waiverOct 6, 2026

National Provider Directory

National Provider Directory

Locations

3010 Fountain Dr
Conway, AR 72034
Phone (501) 328-0055

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1659332849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 FOUNTAIN DRIVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343684",
            "telephone_number": "501-328-0055",
            "fax_number": "501-328-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 FOUNTAIN DRIVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343684",
            "telephone_number": "501-328-0055",
            "fax_number": "501-328-2194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL ARKANSAS PEDIATRICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2016-10-14",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "501-328-0055",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "MC-1956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ID",
            "identifier": "5C289",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139031002",
            "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 Oct 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.