CONWAY REGIONAL MEDICAL CLINIC-PRINCE ST.
NPI 1275990871
Family Medicine in Conway, AR

Active since January 27, 2016CLIA 04D0664530 · Waiver
1 MEDICAL LN, CONWAY, AR 72034(501) 329-2948(501) 450-7243 Get Directions Write a Review

NPPES record last updated: November 9, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 9, 2023, Dec 30, 2019, Jan 27, 2016 (3 updates tracked since 2016).

About Conway Regional Medical Clinic-prince St. NPPES

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

CONWAY REGIONAL MEDICAL CLINIC-PRINCE ST. (NPI 1275990871) is a healthcare organization registered as a family medicine in Conway, Arkansas and active in the NPI registry since January 2016. The organization holds a CLIA Waiver certificate valid through November 17, 2027 and lists William Pack, Cfo, as its authorized official.

NPPES Registry Identity

NPI1275990871
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCONWAY REGIONAL MEDICAL CENTER, INC.
Location Address1 MEDICAL LNConway, AR 72034-4912
Mailing AddressPo Box 9662Conway, AR 72033-9662 · (501) 852-1363 · Fax (501) 852-1364
Fax(501) 450-7243
Organization SubpartNo
Authorized OfficialWilliam PackCfo · (501) 450-2112
Enumeration DateJanuary 27, 2016
Last NPPES UpdateNovember 9, 20233 updates tracked since enumeration
NPPES CertifiedNovember 9, 2023
✔ NPI 1275990871 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.
1 MEDICAL LN, Conway, AR 72034

Other Names 1

Doing Business AsConway Regional Medical Clinic-prince St.

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Conway Regional Medical Clinic-prince St. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

44

Medicare enrollment records show 44 clinicians reassign Medicare billing to Conway Regional Medical Clinic-Prince St., which bills Medicare for the services they deliver. Of these, 2 practice at this address and 21 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 7

Nurse Practitioner19
Family Practice15
Internal Medicine6
Clinical Social Worker1
Hospitalist1
Pediatric Medicine1
Psychiatry1

Nearest to this location (20)

See all 44
Family Practice
NPI 1922629666
1 MEDICAL LN
Conway, AR 72034
(501) 329-2948
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1295193191
1 MEDICAL LN
Conway, AR 72034
(501) 329-2948
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1730851775
2300 ROBINSON AVE
Conway, AR 72034
(501) 548-6100
✔ PECOS✔ Accepts Medicare0.3 mi
Internal Medicine
NPI 1306307657
2302 COLLEGE AVE STE 100
Conway, AR 72034
(501) 513-5385
✔ PECOS✔ Accepts Medicare0.4 mi
Family Practice
NPI 1740442284
2302 COLLEGE AVE STE 100
Conway, AR 72034
(501) 513-5385
✔ PECOS✔ Accepts Medicare0.4 mi
Internal Medicine
NPI 1962865162
2302 COLLEGE AVE STE 100
Conway, AR 72034
(501) 513-5385
✔ PECOS✔ Accepts Medicare0.4 mi
Internal Medicine
NPI 1023059193
2302 COLLEGE AVE STE 100
Conway, AR 72034
(501) 513-5385
✔ PECOS✔ Accepts Medicare0.5 mi
Family Practice
NPI 1093030918
437 DENISON ST
Conway, AR 72034
(501) 327-1325
✔ PECOS✔ Accepts Medicare0.6 mi
Clinical Social Worker
NPI 1508010943
437 DENISON ST
Conway, AR 72034
(501) 852-1363
✔ PECOS✔ Accepts Medicare0.6 mi
Family Practice
NPI 1295732816
437 DENISON ST
Conway, AR 72034
(501) 327-1325
✔ PECOS✔ Accepts Medicare0.6 mi
Family Practice
NPI 1477949238
437 DENISON ST
Conway, AR 72034
(501) 327-1325
✔ PECOS✔ Accepts Medicare0.6 mi
Family Practice
NPI 1578534012
3025 FOUNTAIN DR SUITE 100
Conway, AR 72034
(501) 932-5060
✔ PECOS✔ Accepts Medicare0.9 mi
Hospitalist
NPI 1770014490
1700 ALTUS ST
Conway, AR 72032
(501) 513-5909
✔ PECOS✔ Accepts Medicare1.5 mi
Family Practice
NPI 1134354293
1700 ALTUS ST
Conway, AR 72032
(501) 513-5909
✔ PECOS✔ Accepts Medicare1.5 mi
Nurse Practitioner
NPI 1699763441
1700 ALTUS ST STE 110
Conway, AR 72032
(501) 450-1448
✔ PECOS✔ Accepts Medicare1.5 mi
Nurse Practitioner
NPI 1700207339
1301 MUSEUM RD
Conway, AR 72032
(501) 932-0559
✔ PECOS✔ Accepts Medicare2.4 mi
Nurse Practitioner
NPI 1053810101
1500 MUSEUM RD
Conway, AR 72032
(501) 932-9010
✔ PECOS✔ Accepts Medicare2.5 mi
Nurse Practitioner
NPI 1174847313
587 HIGHWAY 365
Mayflower, AR 72106
(501) 470-7413
✔ PECOS✔ Accepts Medicare9.0 mi
Internal Medicine
NPI 1932137148
587 HWY 365
Mayflower, AR 72106
(501) 470-7413
✔ PECOS✔ Accepts Medicare9.0 mi
Nurse Practitioner
NPI 1598289746
606 HIGHWAY 365
Mayflower, AR 72106
(501) 470-7413
✔ PECOS✔ Accepts Medicare9.1 mi
See all 44 clinicians

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

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 04D0664530

Conway Regional Medical Clinic - Prince Street · Conway, AR
Active · expires Nov 17, 2027
CLIA Number04D0664530
Laboratory TypePhysician Office
Certificate Effective DateNovember 18, 2025
Certificate Expiration DateNovember 17, 2027
Laboratory DirectorMs. Nancy Calvin
Laboratory Phone(501) 329-2948
Laboratory LocationConway Regional Medical Clinic - Prince Street#1 Medical Lane, Conway, AR 72034
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 1275990871. It was assigned to this organization in the NPPES registry on January 27, 2016. The provider is doing business as Conway Regional Medical Clinic-Prince St..

Where is Conway Regional Medical Center, Inc. located?

Conway Regional Medical Center, Inc. is located at 1 Medical Ln, Conway, AR 72034. The listed phone number is (501) 329-2948.

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

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

Is Conway Regional Medical Center, Inc. enrolled in Medicare?

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

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

According to the CMS Revalidation Reassignment List (October 2026 release), 44 clinicians in 7 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 Nurse Practitioner (19), Family Practice (15) and Internal Medicine (6). Of these, 2 practice at this address and 21 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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

Yes. A Certificate of Waiver (number 04D0664530) is associated with this NPI, valid through November 17, 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 Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer 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.