NPIMap

Organization Active NPI

Arkansas Health Group

Doing business as Baptist Health Surgical and Specialty Clinic- Conway

  • Medical Specialty Clinic/Center
  • Conway, AR
National Provider Identifier
1891245221
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
ARKANSAS HEALTH GROUP
Doing business as
Baptist Health Surgical and Specialty Clinic- Conway
Practice address
625 United Dr Ste 270
Conway, AR 72032-7810
Phone
(501) 329-1415
Fax
(501) 329-2589
NPI assigned
Oct 10, 2016
Last updated
Jul 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Authorized official

Name
Mr. Will Rusher
Title
Ceo
Phone
(501) 812-7503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

625 United Dr Ste 270
Conway, AR 72032-7810

Mailing address

11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (501) 812-7215

Other names 1

  • Baptist Health Surgical and Specialty Clinic- Conway Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161129000401 AR Part B Supplier - Clinic/Group Practice 7911802079 Receives reassigned benefits from 5 practitioners
Practice locations: Conway, AR

National Provider Directory

National Provider Directory
Tax ID family
Jeffrey S Mayfield49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

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

View all 48

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • Baptist Health

    dba Baptist Health Family Clinic - Russellville

    • Rural Health Clinic/Center
    • Russellville, AR
    • NPI 1689467102

    Member Of

    NPD member

Locations

625 United Dr
Ste 270
Conway, AR 72032
Phone (501) 329-1415

Practitioners & affiliated clinicians

Practitioners 9

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": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1891245221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "501-812-7215",
            "fax_number": "501-812-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 UNITED DR STE 270",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720327810",
            "telephone_number": "501-329-1415",
            "fax_number": "501-329-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS HEALTH GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "RUSHER",
        "authorized_official_first_name": "WILL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "501-812-7503",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Health Surgical and Specialty Clinic- Conway",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baptist Health Surgical and Specialty Clinic- Conway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.