Northeast Arkansas Pain Medicine

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

E1479 Issued in AR

Legal business name

NORTHEAST ARKANSAS PAIN MEDICINE

Practice address

505 E Matthews Ave
Suite 103
Jonesboro, AR 72401-3144

Phone

(870) 972-0411

Fax

(870) 933-8011

NPI assigned

Mar 12, 2008

Organization subpart

No

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

Authorized official

Name

Monica R Formon

Title

Office Manager

Phone

(870) 972-0411

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Pain Center LLC

  • Ambulatory Surgical Clinic/Center
  • Jonesboro, AR
  • NPI 1578643607

  Member Of

  NPD member

Practitioners 3

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

• Melissa A Hall, APRN

  • Family Nurse Practitioner
  • Jonesboro, AR
  • NPI 1811200959
  Medicare reassignment Care Compare group NPD
• Calin A Savu, M.D.

  • Interventional Pain Medicine Physician
  • Jonesboro, AR
  • NPI 1801976956
  Medicare reassignment Care Compare group NPD
• Amber Michelle Sloan, APN

  • Family Nurse Practitioner
  • Jonesboro, AR
  • NPI 1952515777
  NPD

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260835200000",
    "number": "1235300765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E MATTHEWS AVE",
            "address_2": "SUITE 103",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013144",
            "telephone_number": "870-972-0411",
            "fax_number": "870-933-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E MATTHEWS AVE",
            "address_2": "SUITE 103",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013144",
            "telephone_number": "870-972-0411",
            "fax_number": "870-933-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ARKANSAS PAIN MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2009-12-15",
        "status": "A",
        "authorized_official_last_name": "FORMON",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-972-0411"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AR",
            "license": "E1479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143853002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "5K398",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northeast Arkansas Community Mental Health Center Inc
• Northeast Arkansas Dentistry
• Northeast Arkansas Health System LLC
• Northeast Arkansas Omfs, PLLC
• Northeast Arkansas Orthopaedic and Sports Physical Therapy, Inc.
• Northeast Arkansas Treatment Service
• Northland Hearing Center Inc
• Northland Hearing Centers, Inc.
• Kara Elizabeth Norton, OTR/L
• John M Norwood, MD

• Interventional Pain Medicine Physician in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Interventional Pain Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.