Tri State Interventional Pain Clinic PLLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

TRI STATE INTERVENTIONAL PAIN CLINIC PLLC

Practice address

310 Judge Smith Dr
Marion, AR 72364-2220

Phone

(901) 603-8555

Fax

(901) 730-1229

NPI assigned

Sep 27, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Carol J McCourt, MDNPI 1558337915

Title

Sole Proprietor

Phone

(901) 219-6740

Specialties & licenses 1

Addresses

Practitioners 1

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

• Carol J. McCourt, M.D.

  • Anesthesiology Physician
  • Batesville, AR
  • NPI 1558337915
  NPD Authorized official

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569542400000",
    "number": "1609427939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 LAKE POINTE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258842",
            "telephone_number": "901-219-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 JUDGE SMITH DR",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723642220",
            "telephone_number": "901-603-8555",
            "fax_number": "901-730-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI STATE INTERVENTIONAL PAIN CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-27",
        "last_updated": "2019-09-27",
        "status": "A",
        "authorized_official_last_name": "MCCOURT",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "901-219-6740",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Christy L Tucker, PTA
• Schorlett Turner, MHPP
• Antoinette Tyler, MHPP

• Pain Medicine (Anesthesiology) Physician in Marion, AR
• Providers in Marion, AR by specialty
• Pain Medicine (Anesthesiology) Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.