NPIMap

Organization Active NPI

Pain Treatment Centers of America, PLLC

Doing business as Family Care Centers of America

  • Family Medicine Physician
  • Rolling Fork, MS
National Provider Identifier
1740946573
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PAIN TREATMENT CENTERS OF AMERICA, PLLC
Doing business as
Family Care Centers of America
Practice address
29 S Fourth St
Rolling Fork, MS 39159-5146
Phone
(501) 712-2571
Fax
(501) 404-7789
NPI assigned
Nov 16, 2021
Last updated
Nov 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Authorized official

Name
Kristen Nehk
Title
Chief Billing Operating Officer
Phone
(951) 541-6889

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

29 S Fourth St
Rolling Fork, MS 39159-5146

Mailing address

108 N Shackleford Rd
Little Rock, AR 72211-2840
Phone (501) 712-2571

Other practice location 1

1907 Lisa Drive Ext
Greenville, MS 38703-4429
Phone (501) 712-2571

Other names 1

  • Family Care Centers of America Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://ptcoa.com Direct Pain Treatment Centers of America, PLLC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211104001837 MS Part B Supplier - Clinic/Group Practice 2769608819 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenville, MS; Rolling Fork, MS; Southaven, MS

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Pain Treatment Centers27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Locations

1600 S Colorado St
Greenville, MS 38703
Phone (662) 335-3252

Practitioners & affiliated clinicians

Practitioners 46

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.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637020800000",
    "number": "1740946573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N SHACKLEFORD RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722112840",
            "telephone_number": "501-712-2571",
            "fax_number": "501-404-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 S FOURTH ST",
            "city": "ROLLING FORK",
            "state": "MS",
            "postal_code": "391595146",
            "telephone_number": "501-712-2571",
            "fax_number": "501-404-7789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1907 Lisa Drive Ext",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "MS",
            "postal_code": "387034429",
            "country_code": "US",
            "telephone_number": "501-712-2571",
            "fax_number": "501-404-7789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PAIN TREATMENT CENTERS OF AMERICA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-16",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A",
        "authorized_official_last_name": "NEHK",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "CHIEF BILLING OPERATING OFFICER",
        "authorized_official_telephone_number": "951-541-6889"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://ptcoa.com",
            "affiliation": "Y",
            "endpointDescription": "Practice Website",
            "affiliationName": "Pain Treatment Centers of America, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "29 S Fourth St",
            "city": "Rolling Fork",
            "state": "MS",
            "country_code": "US",
            "postal_code": "391595146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Family Care Centers of America",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rolling Fork, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.