Providence Family Medicine Clinic Inc
NPI 1932690617 · Family Medicine Physician · Conway, AR
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Providence Family Medicine Clinic Inc is a Family Medicine Physician organization in Conway, AR (NPI 1932690617).
Provider details
- NPI number
- 1932690617
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mohammad Idris, President(501) 499-1086
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2018-05-29
- Last updated
- 2018-05-29
Frequently asked questions
- What is Providence Family Medicine Clinic Inc's NPI number?
- Providence Family Medicine Clinic Inc's National Provider Identifier (NPI) is 1932690617, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Providence Family Medicine Clinic Inc?
- Providence Family Medicine Clinic Inc is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Providence Family Medicine Clinic Inc located?
- Providence Family Medicine Clinic Inc's practice location on file with NPPES is 3900 Dave Ward Dr, Conway, AR 72034-5583.
- What is Providence Family Medicine Clinic Inc's phone number?
- The practice phone number listed in the NPPES registry for Providence Family Medicine Clinic Inc is (501) 499-1086.
- Does Providence Family Medicine Clinic Inc accept Medicare?
- Providence Family Medicine Clinic Inc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Providence Family Medicine Clinic Inc?
- The authorized official listed on Providence Family Medicine Clinic Inc's NPPES record is Mohammad Idris, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Providence Family Medicine Clinic Inc's NPI active?
- Yes — Providence Family Medicine Clinic Inc's NPI (1932690617) is active in the NPPES registry as of the last update on 2018-05-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.