NPIMap

Organization Active NPI

Optimal Pain and Wellness

  • Physical Medicine & Rehabilitation Physician
  • Van Buren, AR
National Provider Identifier
1619605094
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
OPTIMAL PAIN AND WELLNESS
Practice address
2925 Alma Hwy Ste C2
Van Buren, AR 72956-5063
Phone
(479) 301-2565
Fax
(479) 301-2717
NPI assigned
Aug 12, 2022
Last updated
Aug 12, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
OPTIMAL PAIN AND WELLNESSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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 connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X NU Primary

Addresses

Primary practice location

2925 Alma Hwy Ste C2
Van Buren, AR 72956-5063

Mailing address

1708 E Joyce Blvd Ste 3
Fayetteville, AR 72703-5251
Phone (479) 301-2565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230306000130 AR DME Supplier - Multi-Specialty - Physician 8325200942 Practice locations: Van Buren, AR

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2168222Optimal Pain and Wellness2925 Alma Hwy C-2, Van Buren, AR 72956Certificate of waiverJun 24, 2027

National Provider Directory

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

Other organizations with this tax ID 3

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

Locations

909 SE 28th St
Ste 5
Bentonville, AR 72712
Phone (479) 273-3376

1678 E Joyce Blvd
#2
Fayetteville, AR 72703
Phone (479) 301-2565

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

Practitioners & affiliated clinicians

Practitioners 9

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": "1660262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1619605094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 E JOYCE BLVD STE 3",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035251",
            "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": "2925 ALMA HWY STE C2",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729565063",
            "telephone_number": "479-301-2565",
            "fax_number": "479-301-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL PAIN AND WELLNESS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPTIMAL PAIN AND WELLNESS",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "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": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Buren, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.