NPIMap

Organization Active NPI

Optimal Pain and Wellness

  • Durable Medical Equipment & Medical Supplies
  • Fayetteville, AR
National Provider Identifier
1316346000
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
OPTIMAL PAIN AND WELLNESS
Practice address
1708 E Joyce Blvd
Ste 3
Fayetteville, AR 72703-5252
Phone
(479) 301-2565
Fax
(479) 301-2717
NPI assigned
Aug 19, 2014
Last updated
Nov 26, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Authorized official

Name
Regina Elizabeth Thurman, MDNPI 1689682353
Title
Owner
Phone
(479) 301-2565

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

1708 E Joyce Blvd
Ste 3
Fayetteville, AR 72703-5252

Mailing address

1708 E Joyce Blvd
Ste 3
Fayetteville, AR 72703-5252
Phone (479) 301-2565

Other identifiers 1

IdentifierTypeStateIssuer
197483716MedicaidAR

National Provider Directory

National Provider Directory
Tax ID family
Optimal Pain and Wellness4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574726400000",
    "number": "1316346000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 E JOYCE BLVD",
            "address_2": "STE 3",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035252",
            "telephone_number": "479-301-2565",
            "fax_number": "479-301-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 E JOYCE BLVD",
            "address_2": "STE 3",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035252",
            "telephone_number": "479-301-2565",
            "fax_number": "479-301-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL PAIN AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-19",
        "last_updated": "2019-11-26",
        "status": "A",
        "authorized_official_last_name": "THURMAN",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-301-2565",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197483716",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.