Active NPI
Carl D Reddig, ED D
- Psychologist
- Conway, AR
National Provider Identifier
1710071949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 9421P
- Practice address
- 350 Salem Road
Ste 1
Conway, AR 72034 - Phone
- (501) 336-8300
- Fax
- (501) 329-3572
- NPI assigned
- Oct 3, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 9421P | AR | Primary |
Addresses
Primary practice location
350 Salem Road
Ste 1
Conway, AR 72034
Mailing address
350 Salem Road
Ste 1
Conway, AR 72034
Phone (501) 336-8300
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9421P | AR | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710071949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 SALEM ROAD",
"address_2": "STE 1",
"city": "CONWAY",
"state": "AR",
"postal_code": "72034",
"telephone_number": "501-336-8300",
"fax_number": "501-329-3572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 SALEM ROAD",
"address_2": "STE 1",
"city": "CONWAY",
"state": "AR",
"postal_code": "72034",
"telephone_number": "501-336-8300",
"fax_number": "501-329-3572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDDIG",
"first_name": "CARL",
"middle_name": "D",
"credential": "ED D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AR",
"license": "9421P",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.