NPIMap

Individual provider Active NPI

Amir Amidi, MD

  • Pain Clinic/Center
  • Fort Smith, AR
National Provider Identifier
1306475470
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
License
E-16590 Issued in AR
Practice address
3017 S 70TH St Ste G
Fort Smith, AR 72903-5000
Phone
(479) 802-4068
NPI assigned
Apr 2, 2020
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X E-16590 AR Primary
Family Medicine Physician 207Q00000X E-16590 AR

Addresses

Primary practice location

3017 S 70TH St Ste G
Fort Smith, AR 72903-5000

Mailing address

3017 S 70TH St Ste FGH
Fort Smith, AR 72903-5049
Phone (479) 802-4068

Other practice location 1

262 W Van Asche Dr
Ste 40
Fayetteville, AR 72703
Phone (844) 215-0731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230731000559 AR Practitioner - Pain Management 7719309913 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Greenbrier Emergency Services, Inc.Group PAC ID 2668377359, 53 clinicians

Practice addresses (Care Compare)

1555 Exchange Ave
Baptist Health Medical Center Conway
Conway, AR 72032-7824
Phone (501) 585-2000

262 W Van Asche Loop
Suite 40
Fayetteville, AR 72703-4996
Phone (877) 215-0731

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-16590ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greenbrier Emergency Services, Inc. CurrentSince Jun 13, 2025 Accepting new patients
Pain Treatment Centers of America PLLC CurrentSince Sep 1, 2023 Accepting new patients
Pain Treatment Centers of America, PLLC CurrentSince Sep 1, 2023 Accepting new patients
Fort Smith Ambulatory Surgery Center, LLC Past Accepting new patients
Bentonville Ambulatory Surgery Center, LLC Past Accepting new patients
Pain Treatment Centers of America, PLLC Family Medicine Past Accepting new patients
Arkansas Health Group Family Medicine PastSince Apr 1, 2020 Accepting new patients
Arkansas Health Group PastSince Apr 1, 2020 Accepting new patients

Locations

1215 Sidney St
Batesville, AR 72501
Phone (870) 262-1541

2902 Mid Cities Dr
Bentonville, AR 72712
Phone (870) 916-5500

1555 Exchange Ave
Conway, AR 72032
Phone (501) 202-2300

262 W Van Asche Loop
#40
Fayetteville, AR 72703
Phone (877) 215-0731

3017 S 70th St
Ste G
Fort Smith, AR 72903
Phone (479) 210-2146

8306 Massard Creek Ct
Fort Smith, AR 72903
Phone (479) 551-8383

3333 Springhill Dr
North Little Rock, AR 72117
Phone (501) 202-3000

4020 Richards Rd
Ste A
North Little Rock, AR 72117
Phone (501) 900-8763

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1306475470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3017 S 70TH ST STE FGH",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035049",
            "telephone_number": "479-802-4068",
            "fax_number": "479-315-5914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3017 S 70TH ST STE G",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035000",
            "telephone_number": "479-802-4068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "262 W Van Asche Dr",
            "address_2": "Ste 40",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "72703",
            "country_code": "US",
            "telephone_number": "844-215-0731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMIDI",
        "first_name": "AMIR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "AR",
            "license": "E-16590",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-16590",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.