Active NPI
Jonathan T Ghormley, M.D.
- Orthopaedic Surgery Physician
- Conway, AR
National Provider Identifier
1982696464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- R3946
- Practice address
- 550 Club Lane
Suite 1
Conway, AR 72034-3681 - Phone
- (501) 329-1510
- Fax
- (501) 329-5697
- NPI assigned
- Aug 19, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | R3946 | AR | Primary |
Addresses
Primary practice location
550 Club Lane
Suite 1
Conway, AR 72034-3681
Mailing address
550 Club Lane
Suite 1
Conway, AR 72034-3681
Phone (501) 329-1510
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 130436716 | Medicaid | AR | |
| 52911 | Other | AR | BCBS |
| 12591000000 | Other | AR | QUALCHOICE |
| 200017919 | Other | AR | RR MEDICARE |
| 115941001 | Medicaid | AR |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- University of Texas Medical Branch at Galveston, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
550 Club LN
Suite 1
Conway, AR 72034-3681
Phone (501) 329-1510
Hospital & facility affiliations
- Conway Regional Medical Center, Inc
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 17 |
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Conway Regional Medical Center Inc. | Orthopaedic Surgery | Current | Accepting new patients |
| Conway Regional Medical Center Inc | Current | Accepting new patients | |
| Conway Regional Medical Center Inc | Past | Accepting new patients |
Locations
550 Club Ln
Ste One
Conway, AR 72034
Phone (501) 329-1510
550 Club Ln
Ste 1
Conway, AR 72034
Phone (501) 329-1510
550 Club Ln
Conway, AR 72034
Phone (501) 327-2414
200 N 3rd St
Ste 3
Dardanelle, AR 72834
Phone (479) 229-4677
Interoperability endpoints
- jonathan.ghormley@1246.chartlogic.direct-ci.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Conway, AR
- NPI 1174092217
-
- Family Medicine Physician
- Conway, AR
- NPI 1043183544
-
- General Acute Care Hospital
- Conway, AR
- NPI 1497770424
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Conway, AR
- NPI 1497770424
-
- Family Medicine Physician
- Russellville, AR
- NPI 1245729359
Hospital
-
- Rural Health Clinic/Center
- Mayflower, AR
- NPI 1851389605
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199059200000",
"number": "1982696464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 CLUB LANE",
"address_2": "SUITE 1",
"city": "CONWAY",
"state": "AR",
"postal_code": "720343681",
"telephone_number": "501-329-1510",
"fax_number": "501-329-5697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 CLUB LANE",
"address_2": "SUITE 1",
"city": "CONWAY",
"state": "AR",
"postal_code": "720343681",
"telephone_number": "501-329-1510",
"fax_number": "501-329-5697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHORMLEY",
"first_name": "JONATHAN",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-19",
"last_updated": "2007-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "AR",
"license": "R3946",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "130436716",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "52911",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUALCHOICE",
"identifier": "12591000000",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "200017919",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "115941001",
"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 Dec 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.