Individual provider Active NPI

C Don Greenway, M.D.

  • Specialist
  • Little Rock, AR
National Provider Identifier
1891799722
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C4718 Issued in AR
Practice address
409 N University Ave
Little Rock, AR 72205-3108
Phone
(501) 664-6980
Fax
(501) 664-4738
NPI assigned
Jun 9, 2005
Last updated
Jul 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X C4718 AR Primary

Addresses

Primary practice location

409 N University Ave
Little Rock, AR 72205-3108

Mailing address

409 N University Ave
Little Rock, AR 72205-3108
Phone (501) 664-6980

Other identifiers 1

IdentifierTypeStateIssuer
104495001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051025000021 AR Practitioner - GastroenterologyPractitioner - Internal Medicine 0648182931 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C4718ARMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Gastro Clinics of Arkansas, PLLC Specialist CurrentSince Jan 1, 2014 Accepting new patients
Arkansas Health Group Past Accepting new patients
Arkansas Gastroenterology Specialist PastSince Jan 1, 2014 Accepting new patients

Locations

409 N University Ave
Little Rock, AR 72205
Phone (501) 246-4561

3401 Springhill Dr
Ste 400
North Little Rock, AR 72117
Phone (501) 945-3343

3401 Springhill Dr
Ste 400A
North Little Rock, AR 72117
Phone (501) 791-3800

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1891799722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 N UNIVERSITY AVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053108",
            "telephone_number": "501-664-6980",
            "fax_number": "501-664-4738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 N UNIVERSITY AVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053108",
            "telephone_number": "501-664-6980",
            "fax_number": "501-664-4738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENWAY",
        "first_name": "C",
        "middle_name": "DON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AR",
            "license": "C4718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104495001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.