NPIMap

Organization Active NPI

Conway Regional Medical Center, Inc

Doing business as Conway Regional Advanced Pain Management Center

  • Pain Clinic/Center
  • Conway, AR
National Provider Identifier
1942713987
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
CONWAY REGIONAL MEDICAL CENTER, INC
Doing business as
Conway Regional Advanced Pain Management Center
Practice address
2200 Ada Ave Ste 301
Conway, AR 72034-4986
Phone
(501) 358-6560
Fax
(501) 358-7341
NPI assigned
Nov 13, 2017
Last updated
Nov 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Authorized official

Name
William Pack
Title
Cfo
Phone
(501) 450-2112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

2200 Ada Ave Ste 301
Conway, AR 72034-4986

Mailing address

PO Box 9662
Conway, AR 72033-9662
Phone (501) 852-1363

Other names 1

  • Conway Regional Advanced Pain Management Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171026001815 AR Part B Supplier - Hospital Department(S) 3173428414 Receives reassigned benefits from 24 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Conway, AR

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Conway Reg Med Ctr Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 8

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": "1510531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1942713987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9662",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720339662",
            "telephone_number": "501-852-1363",
            "fax_number": "501-852-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 ADA AVE STE 301",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344986",
            "telephone_number": "501-358-6560",
            "fax_number": "501-358-7341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY REGIONAL MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-13",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "PACK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "501-450-2112"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conway Regional Advanced Pain Management Center",
            "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 Nov 9, 2023; 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.