NPIMap

Organization Active NPI

Addiction Recovery Medical Services - Providers

  • Pain Medicine (Anesthesiology) Physician
  • Statesville, NC
National Provider Identifier
1669663175
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
9300179 Issued in NC
Legal business name
ADDICTION RECOVERY MEDICAL SERVICES - PROVIDERS
Practice address
536 Signal Hill Dr Ext
Statesville, NC 28625
Phone
(704) 872-0234
Fax
(704) 818-1115
NPI assigned
Aug 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Authorized official

Name
Mr. Bobby Paxton Kearney, MDNPI 1437172012
Title
MD, Medical Director
Phone
(704) 880-5221

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
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X 9300179 NC Primary

Addresses

Primary practice location

536 Signal Hill Dr Ext
Statesville, NC 28625

Mailing address

PO Box 1545
Statesville, NC 28687
Phone (704) 880-4612

Other names 1

  • Bobby P Kearney, MD Pain Management Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070927000409 NC Part B Supplier - Clinic/Group Practice 1456446061 Receives reassigned benefits from 3 practitioners
Practice locations: Statesville, NC

National Provider Directory

National Provider Directory

Locations

536 Signal Hill Drive Ext
Ste 70
Statesville, NC 28625

Practitioners & affiliated clinicians

Practitioners 9

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": "1186531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1669663175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1545",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "28687",
            "telephone_number": "704-880-4612",
            "fax_number": "704-818-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 SIGNAL HILL DR EXT",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "28625",
            "telephone_number": "704-872-0234",
            "fax_number": "704-818-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDICTION RECOVERY MEDICAL SERVICES - PROVIDERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-08",
        "last_updated": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "KEARNEY",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_middle_name": "PAXTON",
        "authorized_official_title_or_position": "MD, MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "704-880-5221",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NC",
            "license": "9300179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bobby P Kearney, MD Pain Management",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.