PAIN CENTER LLC (NPI# 1578643607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1578643607 |
Entity Type | Organization |
Organization Name | PAIN CENTER LLC |
Practice Address |
505 E Matthews Ave Suite 103 Jonesboro AR 72401-3144 |
Practice Telephone | 8709720411 |
Practice Fax Number | 8709338011 |
Mailing Telephone | 8709720411 |
Mailing Fax Number | 8709338011 |
Enumeration Date | 2006-10-16 |
Last Update Date | 2010-11-10 |
Authorized Official Name | MONICA R FORMON (ADMINISTRATOR) |
Authorized Official Telephone | 8709720411 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
AR4148 | AR | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AR | DEPT OF LABOR WA | 0213069 | 01 |
AR | 150029128 | 05 | |
AR | BLUE CROSS PROVIDER NUMBE | 11000 | 01 |
Street Address |
505 E MATTHEWS AVE SUITE 103 |
City | JONESBORO |
State | AR |
Zip Code | 72401-3144 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346248671 | Stephen Randolph Rauls | Obstetrics & Gynecology | 505 E Matthews Ave, Ste 203, Jonesboro, AR 72401-3144 | 2005-07-11 |
1548733678 | Bernice Esther Brown | Nurse Practitioner | 505 E Matthews Ave, Jonesboro, AR 72401-3144 | 2019-01-11 |
1184114928 | Mandy Leonard | Registered Nurse | 505 E Matthews Ave, Jonesboro, AR 72401-3144 | 2018-05-17 |
1881184661 | Natalie Marotti | Registered Nurse | 505 E Matthews Ave, Jonesboro, AR 72401-3144 | 2018-05-16 |
1447796438 | Barbara Cooley | Nurse Practitioner | 505 E Matthews Ave, Jonesboro, AR 72401-3144 | 2017-01-13 |
1588976021 | Elizabeth Jordon Robinson | Nurse Practitioner | 505 E Matthews Ave, Suite 303, Jonesboro, AR 72401-3144 | 2010-07-13 |
1821326141 | Bridget Anne Crouch | Speech-Language Pathologist | 505 E Matthews Ave, Suite 102, Jonesboro, AR 72401-3144 | 2009-11-24 |
1639327679 | Lara Christena Zirbel | Nurse Practitioner | 505 E Matthews Ave, Suite #301, Jonesboro, AR 72401-3144 | 2008-09-03 |
1235300765 | Northeast Arkansas Pain Medicine | Pain Medicine | 505 E Matthews Ave, Suite 103, Jonesboro, AR 72401-3144 | 2008-03-12 |
1477749992 | Michelle Wingo | Physician Assistant | 505 E Matthews Ave, Suite 303, Jonesboro, AR 72401-3144 | 2007-09-18 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
Find all providers in zip 72401 |
Taxonomy Code | 261QA1903X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Ambulatory Surgical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
1639615297 | Surgery Center At The Reserve, P.a., Inc. | Clinic/Center | 2241 Hillpark Cove, Suite B, Jonesboro, AR 72401 | 2017-01-06 |
1598758153 | Outpatient Surgery Center of Jonesboro LLC | Clinic/Center | 1100 E Matthews Ave, Jonesboro, AR 72401-4314 | 2005-08-29 |
1386165504 | Emory Clinic Inc | Clinic/Center | 7813 Spivey Station Blvd, Jonesboro, GA 30236-2900 | 2017-06-28 |
1487012480 | Lake Spivey Ambulatory Surgery Care, LLC | Clinic/Center | 7813 Spivey Station Blvd, Suite 100, Jonesboro, GA 30236-2900 | 2016-02-04 |
1528478849 | Vein Specialists of Arkansas | Clinic/Center | 2239 S Caraway Rd, Suite N, Jonesboro, AR 72401-6204 | 2014-05-08 |
1558562579 | International Center for Foot & Ankle Surgery | Clinic/Center | 7130 Mount Zion Blvd, Suite 14, Jonesboro, GA 30236-2566 | 2007-05-29 |
1508974353 | Southlake Ambulatory Surgery Center, Lllp | Clinic/Center | 7813 Spivey Station Blvd, Suite 100, Jonesboro, GA 30236-0000 | 2006-08-29 |
1457379364 | Jonesboro Surgery Center, LLC | Clinic/Center | 623 E Matthews Ave, Suite C, Jonesboro, AR 72401-3145 | 2006-07-18 |
1720023500 | Center for Reconstructive Surgery | Clinic/Center | 7130 Mount Zion Blvd, Suite 14, Jonesboro, GA 30236-2518 | 2006-06-17 |
Find all providers in JONESBORO |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.