Individual provider Active NPI

Regina Elizabeth Thurman, MD

  • Physical Medicine & Rehabilitation Physician
  • Fayetteville, AR
National Provider Identifier
1689682353
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
E-4490 Issued in AR
Practice address
1708 E Joyce Blvd
Fayetteville, AR 72703-5252
Phone
(479) 301-2565
Fax
(479) 301-2717
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X E-4490 AR Primary

Addresses

Primary practice location

1708 E Joyce Blvd
Fayetteville, AR 72703-5252

Mailing address

1708 E Joyce Blvd
Fayetteville, AR 72703-5252
Phone (479) 301-2565

Other identifiers 1

IdentifierTypeStateIssuer
E-4490OtherARSTATE LICENSE

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
I20070203000167 AR Practitioner - Physical Medicine and Rehabilitation 1557363538 Reassigns benefits to 1 organization
Practice locations: Conway, AR

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Arkansas College of Medicine, 2002
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Optimal Pain and WellnessGroup PAC ID 8325200942, 4 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Pain and Wellness Physical Medicine & Rehabilitation CurrentSince Apr 16, 2012 Accepting new patients
Ancillary Innovations Current Accepting new patients
Optimal Pain and Wellness Physical Medicine & Rehabilitation CurrentSince Apr 16, 2012 Accepting new patients

Locations

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

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

Interoperability endpoints

  • Direct secure messaging: regina.thurman@4085.securemail.prognocis.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1689682353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 E JOYCE BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035252",
            "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": "1708 E JOYCE BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035252",
            "telephone_number": "479-301-2565",
            "fax_number": "479-301-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THURMAN",
        "first_name": "REGINA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AR",
            "license": "E-4490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "E-4490",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.