Individual provider Active NPI

Michael Stephen Adams, M.D.

  • Interventional Pain Medicine Physician
  • Mena, AR
National Provider Identifier
1407098890
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
E-10204 Issued in AR
Practice address
1102 Crestwood Cir
Mena, AR 71953-5513
Phone
(479) 234-4433
Fax
(479) 234-4445
NPI assigned
Mar 31, 2009
Last updated
Oct 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X E-10204 AR
Pain Medicine (Anesthesiology) Physician 207LP2900X E-10204 AR
Interventional Pain Medicine Physician 208VP0014X E-10204 AR Primary

Addresses

Primary practice location

1102 Crestwood Cir
Mena, AR 71953-5513

Mailing address

1102 Crestwood Cir
Mena, AR 71953-5513
Phone (479) 234-4433

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170511000455 AR Practitioner - AnesthesiologyPractitioner - Pain Management 2668615170 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Indiana University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Pain Therapy Mena Clinic LLCGroup PAC ID 0446698070, 3 clinicians

Practice addresses (Care Compare)

1102 Crestwood Cir
Mena, AR 71953-5513
Phone (479) 234-4433

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-10204ARMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelinc Anesthesia V, P.a. Anesthesiology CurrentSince Jan 6, 2020 Accepting new patients
Arkansas Pain Therapy Mena Clinic LLC Pain Medicine CurrentSince Mar 1, 2024 Accepting new patients

Locations

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

1102 Crestwood Cir
Mena, AR 71953
Phone (479) 234-4433

3340 Players Club Pkwy
Ste 350
Memphis, TN 38125
Phone (901) 207-2017

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CEHDDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/CEHDDD/Endpoint/CEHDDD

Organizations & group practices 2

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 1

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": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1407098890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 CRESTWOOD CIR",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719535513",
            "telephone_number": "479-234-4433",
            "fax_number": "479-234-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 CRESTWOOD CIR",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719535513",
            "telephone_number": "479-234-4433",
            "fax_number": "479-234-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "MICHAEL",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-31",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E-10204",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AR",
            "license": "E-10204",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AR",
            "license": "E-10204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mena, AR

Sources for this page

Verify at the official NPI Registry.