Organization Active NPI

Pain Care Associates P a

  • Chiropractor
  • Little Rock, AR
National Provider Identifier
1174535124
Registry record updated Jul 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC-2108 Issued in AR
Legal business name
PAIN CARE ASSOCIATES P A
Practice address
8801 W Markham St
Little Rock, AR 72205-2316
Phone
(501) 223-3314
Fax
(501) 223-8023
NPI assigned
Aug 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dwight K Stewart, D.C.
Title
Officer
Phone
(501) 223-3314

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X MC-2108 AR Primary

Addresses

Primary practice location

8801 W Markham St
Little Rock, AR 72205-2316

Mailing address

8801 W Markham St
Little Rock, AR 72205-2316
Phone (501) 223-3314

Other identifiers 2

IdentifierTypeStateIssuer
5B321OtherARAR HEALTH ADVANTGE HMO
5B321OtherARBLUE CROSS BLUE SHIELD

Other names 1

  • Pain Care Medical Associates Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315000988 AR Part B Supplier - Clinic/Group Practice 8820987845 Receives reassigned benefits from 3 practitioners
Practice locations: Little Rock, AR

National Provider Directory

National Provider Directory

Locations

1911 Military Rd
Ste 1
Benton, AR 72015
Phone (501) 315-6390

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310515200000",
    "number": "1174535124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8801 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722052316",
            "telephone_number": "501-223-3314",
            "fax_number": "501-223-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8801 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722052316",
            "telephone_number": "501-223-3314",
            "fax_number": "501-223-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CARE ASSOCIATES P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2011-07-13",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "501-223-3314",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "MC-2108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR HEALTH ADVANTGE HMO",
            "identifier": "5B321",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5B321",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain Care Medical Associates",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.