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CONWAY ORTHOPEDIC AND SPORTS MEDICINE CENTER
NPI 1174092217
Orthopaedic Surgery in Conway, AR

Active since November 19, 2018
550 CLUB LN STE 1, CONWAY, AR 72034(501) 329-1510(501) 329-5697 Get Directions Write a Review

NPPES record last updated: November 9, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 9, 2023, May 12, 2020, Jan 2, 2020 and 2 more (5 updates tracked since 2018).

About Conway Orthopedic And Sports Medicine Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONWAY ORTHOPEDIC AND SPORTS MEDICINE CENTER (NPI 1174092217) is a healthcare organization registered as an orthopaedic surgery in Conway, Arkansas and active in the NPI registry since November 2018. The organization lists William Pack, Cfo, as its authorized official.

NPPES Registry Identity

NPI1174092217
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameCONWAY REGIONAL MEDICAL CENTER INC.
Location Address550 CLUB LN STE 1Conway, AR 72034-3681
Mailing Address550 Club Ln Ste 1Conway, AR 72034-3681 · (501) 329-1510 · Fax (501) 329-5697
Phone(501) 329-1510
Fax(501) 329-5697
Organization SubpartNo
Authorized OfficialWilliam PackCfo · (501) 450-2112
Enumeration DateNovember 19, 2018
Last NPPES UpdateNovember 9, 20235 updates tracked since enumeration
NPPES CertifiedNovember 9, 2023
✔ NPI 1174092217 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Also ListedPodiatristTaxonomy 213E00000X
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
550 CLUB LN STE 1, Conway, AR 72034
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Other Names 1

Doing Business AsConway Orthopedic And Sports Medicine Center

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Conway Orthopedic And Sports Medicine Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateArkansasEnrollment IDO20200604002045DME · Physician - Orthopedic/Orthopedic SurgeryDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

12

Medicare enrollment records show 12 clinicians reassign Medicare billing to Conway Orthopedic And Sports Medicine Center, which bills Medicare for the services they deliver. Of these, 10 practice at this address and 12 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 2

Orthopedic Surgery9
Nurse Practitioner3

Clinicians, nearest first (12)

Austin Cole, MD
Orthopedic Surgery
NPI 1093209090
550 CLUB LN
Conway, AR 72034
(501) 329-1510
✔ PECOS✔ Accepts MedicareSame address
Tiffany Epperson, APRN
Nurse Practitioner
NPI 1578970364
550 CLUB LN SUITE 1
Conway, AR 72034
(501) 329-1510
✔ PECOS✔ Accepts MedicareSame address
Bryan Head, M.D.
Orthopedic Surgery
NPI 1003264789
550 CLUB LN STE 1
Conway, AR 72034
(501) 329-1510
✔ PECOS✔ Accepts MedicareSame address
Hannah Ray
Nurse Practitioner
NPI 1972287415
550 CLUB LN STE 1
Conway, AR 72034
(501) 329-1510
✔ PECOS✔ Accepts MedicareSame address
Jordan Walters
Orthopedic Surgery
NPI 1124472410
550 CLUB LN STE 1
Conway, AR 72034
(501) 329-1510
✔ PECOS✔ Accepts MedicareSame address
James Head, MD
Orthopedic Surgery
NPI 1144541210
550 CLUB LN
Conway, AR 72034
(501) 329-1510
✔ PECOS✔ Accepts MedicareSame address
Jonathan Ghormley, M.D.
Orthopedic Surgery
NPI 1982696464
550 CLUB LANE SUITE 1
Conway, AR 72034
(501) 329-1510
✔ PECOS✔ Accepts MedicareSame address
James Howell, MD
Orthopedic Surgery
NPI 1073771671
550 CLUB LANE SUITE 1
Conway, AR 72034
(501) 329-1510
✔ PECOS✔ Accepts MedicareSame address
Robert Mccarron, M.D.
Orthopedic Surgery
NPI 1073505541
550 CLUB LANE SUITE 1
Conway, AR 72034
(501) 329-1510
✔ PECOS✔ Accepts MedicareSame address
Harry Smith, M.D.
Orthopedic Surgery
NPI 1144212523
550 CLUB LANE SUITE 1
Conway, AR 72034
(501) 329-1510
✔ PECOS✔ Accepts MedicareSame address
Thomas Roberts, M.D.
Orthopedic Surgery
NPI 1508858036
525 WESTERN AVE STE 302
Conway, AR 72034
(501) 504-6649
✔ PECOS✔ Accepts Medicare1.0 mi
Heather Steely, APRN
Nurse Practitioner
NPI 1982902383
2200 ADA AVE STE 301
Conway, AR 72034
(501) 358-6560
✔ PECOS✔ Accepts Medicare1.0 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Conway Regional Medical Center Inc.'s NPI number?

The NPI number for Conway Regional Medical Center Inc. is 1174092217. It was assigned to this organization in the NPPES registry on November 19, 2018. The provider is doing business as Conway Orthopedic And Sports Medicine Center.

Where is Conway Regional Medical Center Inc. located?

Conway Regional Medical Center Inc. is located at 550 Club Ln Ste 1, Conway, AR 72034. The listed phone number is (501) 329-1510.

What is Conway Regional Medical Center Inc.'s specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Conway Regional Medical Center Inc. enrolled in Medicare?

Yes. Conway Regional Medical Center Inc. is registered in the Medicare PECOS enrollment system.

When is Conway Regional Medical Center Inc.'s Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Arkansas, Physician - Orthopedic/Orthopedic Surgery) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Conway Regional Medical Center Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians in 2 Medicare specialties reassign their Medicare billing to Conway Regional Medical Center Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Orthopedic Surgery (9) and Nurse Practitioner (3). Of these, 10 practice at this address and 12 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Conway Regional Medical Center Inc. accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 4 other insurers list Conway Regional Medical Center Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Conway Regional Medical Center Inc. was last updated on November 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.