NPIMap

Organization Active NPI

Dr Q Pain & Spine Clinic, PA

Doing business as Arkansas Spine and Pain

  • Physical Medicine & Rehabilitation Physician
  • Jacksonville, AR
National Provider Identifier
1649784562
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
DR Q PAIN & SPINE CLINIC, PA
Doing business as
Arkansas Spine and Pain
Practice address
140 John Harden Dr Ste 6
Jacksonville, AR 72076-3786
Phone
(501) 227-0184
Fax
(501) 251-1975
NPI assigned
Nov 30, 2017
Organization subpart
Yes
Parent organization
DR. Q PAIN & SPINE, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Authorized official

Name
Paula Ann Welch
Title
Administrator
Phone
(501) 227-0184

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

140 John Harden Dr Ste 6
Jacksonville, AR 72076-3786

Mailing address

5700 W Markham St
Little Rock, AR 72205-3328
Phone (501) 227-0184

Other identifiers 1

IdentifierTypeStateIssuer
179747002MedicaidAR

Other names 1

  • Arkansas Spine and Pain Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091120000013 AR Part B Supplier - Clinic/Group Practice 1052450665 Receives reassigned benefits from 15 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Benton, AR; Conway, AR; Jacksonville, AR; Little Rock, AR; Searcy, AR; White Hall, AR

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Dr Q Pain Spine Clinic PA

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543881600000",
    "number": "1649784562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053328",
            "telephone_number": "501-227-0184",
            "fax_number": "501-251-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 JOHN HARDEN DR STE 6",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720763786",
            "telephone_number": "501-227-0184",
            "fax_number": "501-251-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR Q PAIN & SPINE CLINIC, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR. Q PAIN & SPINE, PA",
        "enumeration_date": "2017-11-30",
        "last_updated": "2018-12-04",
        "status": "A",
        "authorized_official_last_name": "WELCH",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "501-227-0184"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179747002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arkansas Spine and Pain",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Arkansas Spine and Pain",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.