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CONWAY REGIONAL MEDICAL CLINIC-RUSSELLVILLE
NPI 1245729359
Family Medicine in Russellville, AR

Active since May 03, 2018CLIA 04D0468970 · Waiver
108 SKYLINE DR, RUSSELLVILLE, AR 72801(479) 968-7170(479) 968-7607 Get Directions Write a Review

NPPES record last updated: November 9, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 9, 2023, Dec 30, 2019, May 3, 2018 (3 updates tracked since 2018).

About Conway Regional Medical Clinic-russellville NPPES

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

CONWAY REGIONAL MEDICAL CLINIC-RUSSELLVILLE (NPI 1245729359) is a healthcare organization registered as a family medicine in Russellville, Arkansas and active in the NPI registry since May 2018. The organization holds a CLIA Waiver certificate valid through May 15, 2027 and lists William Pack, Cfo, as its authorized official.

NPPES Registry Identity

NPI1245729359
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCONWAY REGIONAL MEDICAL CENTER, INC
Location Address108 SKYLINE DRRussellville, AR 72801-3362
Mailing AddressPo Box 9662Conway, AR 72033-9662 · (501) 852-1363 · Fax (501) 852-1364
Phone(479) 968-7170
Fax(479) 968-7607
Organization SubpartNo
Authorized OfficialWilliam PackCfo · (501) 450-2112
Enumeration DateMay 3, 2018
Last NPPES UpdateNovember 9, 20233 updates tracked since enumeration
NPPES CertifiedNovember 9, 2023
✔ NPI 1245729359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
108 SKYLINE DR, Russellville, AR 72801
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Other Names 1

Doing Business AsConway Regional Medical Clinic-russellville

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 04D0468970

Conway Regional Medical Clinic -Russellville · Russellville, AR
Active · expires May 15, 2027
CLIA Number04D0468970
Laboratory TypeRural Health Clinic
Certificate Effective DateMay 16, 2025
Certificate Expiration DateMay 15, 2027
Laboratory DirectorDebra Thrasher
Laboratory Phone(479) 968-7170
Laboratory LocationConway Regional Medical Clinic -Russellville108 Skyline Drive, Russellville, AR 72801
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KENNETH B TURNER MD
Family Medicine
108 SKYLINE DR
RUSSELLVILLE, AR 72801
Pope County (479) 968-7170
RUSSELLVILLE FAMILY CLINIC PA
Family Medicine
108 SKYLINE DR
RUSSELLVILLE, AR 72801
Pope County (479) 968-7170
LAUREN MARIE ADKISON PA-C
Physician Assistant
108 SKYLINE DR
RUSSELLVILLE, AR 72801
Pope County (479) 968-7170
BRECKENN LEIGH FINDLEY APN
Nurse Practitioner (Family)
108 SKYLINE DR
RUSSELLVILLE, AR 72801
Pope County (479) 968-7170
LAVON JENEEN WOOD M. D.
Family Medicine
108 SKYLINE DR
RUSSELLVILLE, AR 72801
Pope County (479) 968-7170
COBBS WESTSIDE PHARMACY INC
Pharmacy (Community/Retail Pharmacy)
108 SKYLINE DR, STE B
RUSSELLVILLE, AR 72801
Pope County (479) 968-7180
DR. BENJAMIN BOWER MD
Family Medicine
108 SKYLINE DR
RUSSELLVILLE, AR 72801
Pope County (479) 968-7170
DR. CRYSTAL LYNN KIBLER DNP, APRN, FNP-C
Nurse Practitioner (Family)
108 SKYLINE DR
RUSSELLVILLE, AR 72801
Pope County (479) 968-7170

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 1245729359. It was assigned to this organization in the NPPES registry on May 3, 2018. The provider is doing business as Conway Regional Medical Clinic-Russellville.

Where is Conway Regional Medical Center, Inc located?

Conway Regional Medical Center, Inc is located at 108 Skyline Dr, Russellville, AR 72801. The listed phone number is (479) 968-7170.

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

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Conway Regional Medical Center, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D0468970) is associated with this NPI, valid through May 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Conway Regional Medical Center, Inc accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 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.