NPIMap

Pain Treatment Centers of America PLLC

Organization Active NPI Durable Medical Equipment & Medical Supplies · Fayateville, AR

NPI 1821702846 · NPPES record last updated Jul 12, 2023

Key facts

NPI
1821702846
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Legal business name
PAIN TREATMENT CENTERS OF AMERICA PLLC
Practice address
262 West Van Asche Loop
Suite 40
Fayateville, AR 72703-0040
Phone
(501) 712-2571
Fax
(501) 404-7789
NPI assigned
Jan 13, 2023
Organization subpart
No

Authorized official

Name
Kristen Nehk
Title
Coo of RCM Services
Phone
(951) 541-6889

Other NPIs with the same Medicare PAC ID 20

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

Corporate family (same tax ID) 26

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

View all 26

Practitioners 73

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

View all 73

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2258614Pain Treatment Centers of America
262 W Van Ashe Loop Suite 40, Fayetteville, AR 72703		Certificate of waiverApr 24, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230714001085 AR DME Supplier - Physician - Unknown Physician Specialty
DME Supplier - Independently-Practicing Physical Therapist		 2769608819 Practice locations: Fayetteville, AR

National Provider Directory

Tax ID family
Pain Treatment Centers of America (27 organizations share this tax ID)

Locations

262 W Van Asche Loop
Fayetteville, AR 72703

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Yes

Addresses

Primary practice location

262 West Van Asche Loop
Suite 40
Fayateville, AR 72703-0040

Mailing address

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

Sources for this page

Verify at the official NPI Registry.