NPIMap

University of Arkansas for Medical Science

Organization Active NPI Otolaryngology Physician · Conway, AR

NPI 1760058895 · NPPES record last updated Mar 30, 2022

Key facts

NPI
1760058895
Entity type
Organization (NPI type 2)
Primary specialty
Otolaryngology Physician 207Y00000X
Legal business name
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCE
Practice address
2425 Dave Ward Dr Ste 101
Conway, AR 72034-8679
Phone
(501) 932-7600
Fax
(501) 932-7603
NPI assigned
May 30, 2021
Organization subpart
Yes
Parent organization (as reported)
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES

Authorized official

Name
Amanda D George
Title
Vice Chancellor-Chief Financial Off
Phone
(501) 686-5670

Other NPIs on the same Medicare enrollment 22

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

Corporate family (same tax ID) 24

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

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 38

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031219000706 AR Part B Supplier - Clinic/Group Practice 4082528955 Receives reassigned benefits from 2,092 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Little Rock, AR; Maumelle, AR; North Little Rock, AR; Springdale, AR; Alexander, AR; Bentonville, AR; Cabot, AR; Conway, AR…

National Provider Directory

Tax ID family
Karen Atkin (111 organizations share this tax ID)
Part of
Karen Atkin

Locations

2425 Dave Ward Dr
Ste 1101
Conway, AR 72034
Phone (501) 932-7600

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Y00000X Yes
Audiologist
Group: 193200000X MULTI-SPECIALTY GROUP		 231H00000X

Addresses

Primary practice location

2425 Dave Ward Dr Ste 101
Conway, AR 72034-8679

Mailing address

2425 Dave Ward Dr Ste 1101
Conway, AR 72034-8686
Phone (501) 932-7600

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 30, 2022.

{
    "created_epoch": "1622332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1760058895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 DAVE WARD DR STE 1101",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720348686",
            "telephone_number": "501-932-7600",
            "fax_number": "501-932-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 DAVE WARD DR STE 101",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720348679",
            "telephone_number": "501-932-7600",
            "fax_number": "501-932-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES",
        "enumeration_date": "2021-05-30",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE CHANCELLOR-CHIEF FINANCIAL OFF",
        "authorized_official_telephone_number": "501-686-5670"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

All providers in Conway, AR · Otolaryngology Physician in Arkansas

Sources for this page

Verify at the official NPI Registry.