Active NPI
David Craig Shirley, M.D.
- Urology Physician
- Conway, AR
National Provider Identifier
1770582041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- N-7212
- Practice address
- 495 Hogan Lane
Suite 2
Conway, AR 72034 - Phone
- (501) 327-5850
- Fax
- (501) 327-4910
- NPI assigned
- Jul 19, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | N-7212 | AR | Primary |
Addresses
Primary practice location
495 Hogan Lane
Suite 2
Conway, AR 72034
Mailing address
495 Hogan Lane
Suite 2
Conway, AR 72034
Phone (501) 327-5850
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113501001 | Medicaid | AR |
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 Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321833600000",
"number": "1770582041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "495 HOGAN LANE",
"address_2": "SUITE 2",
"city": "CONWAY",
"state": "AR",
"postal_code": "72034",
"telephone_number": "501-327-5850",
"fax_number": "501-327-4910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "495 HOGAN LANE",
"address_2": "SUITE 2",
"city": "CONWAY",
"state": "AR",
"postal_code": "72034",
"telephone_number": "501-327-5850",
"fax_number": "501-327-4910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIRLEY",
"first_name": "DAVID",
"middle_name": "CRAIG",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-19",
"last_updated": "2011-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "AR",
"license": "N-7212",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "113501001",
"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 Nov 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.