RUSSELL DERMATOLOGY OF CONWAY, PLLC
NPI 1639134067
Dermatology in Conway, AR
NPI Status: Active since April 19, 2006
Contact Information
2425 DAVE WARD DR
SUITE 202
CONWAY, AR
ZIP 72034
Phone: (501) 328-5050
Fax: (501) 328-2131
- Organization
- Dermatology
- Accepts Insurance
- CLIA Number: 04D0976193
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-18-2025
About RUSSELL DERMATOLOGY OF CONWAY, PLLC
This page provides the complete NPI Profile along with additional information for Russell Dermatology Of Conway, Pllc, a provider established in Conway, Arkansas operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1639134067 assigned on April 2006. The practitioner's primary taxonomy code is 207N00000X with license number E1574 (AR). The provider is registered as an organization and their NPI record was last updated 15 years ago. Russell Dermatology Of Conway, Pllc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Mrs. Jackie D Russell (Bus/office Mgr)
- NPI
- 1639134067
- Provider Name
- RUSSELL DERMATOLOGY OF CONWAY, PLLC
- Entity Type
- Organization
- Location Address
- 2425 DAVE WARD DR SUITE 202 CONWAY, AR 72034
- Location Phone
- (501) 328-5050
- Location Fax
- (501) 328-2131
- Mailing Address
- 2425 DAVE WARD DR SUITE 202 CONWAY, AR 72034
- Mailing Phone
- (501) 328-5050
- Mailing Fax
- (501) 328-2131
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-19-2006
- Last Update Date
- 10-28-2010
- Code Navigator
A dermatologist like Russell Dermatology Of Conway, Pllc is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology
- Taxonomy Code
- 207N00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- E1574
- License State
- AR
- Taxonomy Description
- A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA (QualChoice) - POS
- Complete Gold - PPO
- Complete Gold + Vision + Adult Dental - PPO
- Complete Silver (QualChoice) - POS
- Connected Silver - PPO
- Connected Silver (QualChoice) - POS
- Connected Silver (QualChoiceLife) - PPO
- Connected Silver + Vision + Adult Dental - PPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold - PPO
- Elite Gold + Vision + Adult Dental - PPO
- Everyday Bronze - PPO
- Everyday Bronze + Vision + Adult Dental - PPO
- Everyday Gold - PPO
- Everyday Gold + Vision + Adult Dental - PPO
- Focused Silver - PPO
- Focused Silver + Vision + Adult Dental - PPO
- Clear Silver - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5C773 | MEDICARE ID-TYPE UNSPECIFIED (04) | AR | MEDICARE |
| 140625002 | MEDICAID (05) | AZ |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 04D0976193
- Facility Type
- Physician Office
- Certificate Effective Date
- December 19, 2023
- Certificate Expiration Date
- December 18, 2025
- Laboratory Director
- DR. BRIAN E. RUSSELL
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Russell Dermatology Of Conway, Pllc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
Reviews for RUSSELL DERMATOLOGY OF CONWAY, PLLC
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 3 | 9 | 1 | 3 | 4 | 0 | 6 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 6 | 9 | 2 | 3 | 8 | 0 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 6 + 9 + 2 + 3 + 8 + 0 + 1 + 2 + 24 = 63 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 63 = 7 | 7 | ||||||||
The NPI number 1639134067 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1265419774 | RANDAL G BOWLIN MD Individual | Family Medicine | 2425 DAVE WARD DR STE 401 CONWAY, AR 72034 (501) 329-3824 |
| 1063499150 | JOE C CUMMINS MD Individual | Family Medicine | 2425 DAVE WARD DR SUITE 401 CONWAY, AR 72034 (501) 329-3824 |
| 1861479966 | LANDER A SMITH MD Individual | Family Medicine | 2425 DAVE WARD DR SUITE 401 CONWAY, AR 72034 (501) 329-3824 |
| 1730166844 | DAVID L NAYLOR MD Individual | Family Medicine | 2425 DAVE WARD DR STE 401 CONWAY, AR 72034 (501) 329-3824 |
| 1457330011 | DR. SHELLEY W RUSSELL M.D. Individual | Dermatology | 2425 DAVE WARD DR SUITE 202 CONWAY, AR 72034 (501) 328-5050 |
| 1033198510 | DR. ERIC BRIAN RUSSELL M.D. Individual | Dermatology | 2425 DAVE WARD DR SUITE 202 CONWAY, AR 72034 (501) 328-5050 |
| 1477522217 | SELECT PHYSICAL THERAPY HOLDINGS INC Organization | Clinic/Center (Physical Therapy) | 2425 DAVE WARD DR NUMBER 103 CONWAY, AR 72034 (501) 327-1730 |
| 1407811169 | DR. DAVID MICHAEL ARNOLD M.D. Individual | Orthopaedic Surgery (Orthopaedic Surgery of the Spine) | 2425 DAVE WARD DR SUITE 201 CONWAY, AR 72034 (501) 329-7246 |
| 1558536219 | MS. KATHLEEN E. PHILLIPS M.S., CCC-A Individual | Audiologist | 2425 DAVE WARD DR SUITE 101 CONWAY, AR 72034 (501) 932-7600 |
| 1902043227 | SAINT-MARK ENTERPRISES 1890 LLC Organization | Pharmacy (Community/Retail Pharmacy) | 2425 DAVE WARD DR SUITE 602 CONWAY, AR 72034 (501) 329-7777 |
| 1558667683 | ANNETTE N. ANDERSON, MD, PA Organization | Psychiatry & Neurology (Geriatric Psychiatry) | 2425 DAVE WARD DR SUITE 102 CONWAY, AR 72034 (501) 932-0480 |
| 1740481274 | TRUDY DAVIS FORBUSH PHYSICAL THERAPIST Individual | Physical Therapist | 2425 DAVE WARD DR CONWAY, AR 72034 (501) 327-1730 |
| 1861455057 | BOWLIN-CUMMINS PA Organization | Clinic/Center (Rural Health) | 2425 DAVE WARD DR STE 401 CONWAY, AR 72034 (501) 329-3824 |
| 1992180269 | NATALIE CLAIRE BROWND APRN Individual | Nurse Practitioner (Family) | 2425 DAVE WARD DR SUITE #401 CONWAY, AR 72034 (501) 329-3824 |
| 1962862557 | MRS. RACHEL CHOATE MSN, APRN, FNP-C Individual | Nurse Practitioner (Family) | 2425 DAVE WARD DR SUITE 202 CONWAY, AR 72034 (501) 328-5050 |
| 1871990937 | THE PAIN MEDICINE CONSULTANTS GROUP Organization | Durable Medical Equipment & Medical Supplies | 2425 DAVE WARD DR GORDY BUILDING STE 102 CONWAY, AR 72034 (501) 764-1150 |
| 1114461118 | DR. LEAH MARIE LAMB Individual | Pharmacist | 2425 DAVE WARD DR SUITE 602 CONWAY, AR 72034 (501) 329-3777 |
| 1023099009 | DAVID WILLIAM SMITH P.D. Individual | Pharmacist | 2425 DAVE WARD DR STE. 602 CONWAY, AR 72034 (501) 329-3777 |
| 1790776912 | JJJ SMITH, INC Organization | Pharmacist | 2425 DAVE WARD DR STE. 602 CONWAY, AR 72034 (501) 329-3777 |
| 1336498492 | DR. MATTHEW CLIFF BROWN AU.D. Individual | Audiologist | 2425 DAVE WARD DR CONWAY, AR 72034 (501) 932-7600 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639134067, enumerated in the NPI registry as an "organization" on April 19, 2006
The provider is located at 2425 Dave Ward Dr Suite 202 Conway, Ar 72034 and the phone number is (501) 328-5050
This medical organization specializes in Dermatology with taxonomy code 207N00000X
The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 04D0976193 for a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on April 19, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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