NPIMap

Individual provider Active NPI

Nicholas Benjamin Camp, MD

  • Pain Medicine (Anesthesiology) Physician
  • Bentonville, AR
National Provider Identifier
1861753709
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
E-10371 Issued in AR
Practice address
2900 Medical Center Pkwy Ste 110
Bentonville, AR 72712-3212
Phone
(479) 715-4262
Fax
(866) 817-7601
NPI assigned
Jun 7, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 2017004412 MO
Pain Medicine (Anesthesiology) Physician 207LP2900X E-10371 AR Primary

Addresses

Primary practice location

2900 Medical Center Pkwy Ste 110
Bentonville, AR 72712-3212

Mailing address

2900 Medical Center Pkwy Ste 110
Bentonville, AR 72712-3212
Phone (479) 715-4262

Other practice location 1

3125 Dr Russell Smith Way
Carthage, MO 64836-7402
Phone (501) 821-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170706002212 MO Practitioner - AnesthesiologyPractitioner - Pain Management 3577705706 Reassigns benefits to 2 organizations
I20181204001949 AR Practitioner - AnesthesiologyPractitioner - Pain Management 3577705706 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
University of Arkansas College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital Carthage 23 clinicians

Practice addresses (Care Compare)

3125 Dr Russell Smith Way
Mercy Carthage Pain Medicine
Carthage, MO 64836-7402
Phone (417) 359-1829

Hospital & facility affiliations

  • Mercy Hospital Carthage Hospital, Carthage, MO, CCN 261338
  • Ozarks Community Hospital of Gravette Hospital, Gravette, AR, CCN 041331
  • Mercy Specialty Hospital Southeast Kansas Hospital, Galena, KS, CCN 170203
  • Mercy Hospital Joplin Hospital, Joplin, MO, CCN 260001
  • Mercy Hospital Pittsburg, Inc Hospital, Pittsburg, KS, CCN 170006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-10371ARMDPain Medicine (Anesthesiology) Physician
2017004412MOMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sgoh Acquisition Inc CurrentSince Sep 15, 2020 Accepting new patients
Sgoh Acquisition Inc CurrentSince Sep 15, 2020 Accepting new patients
Mercy Hospital Carthage CurrentSince Apr 18, 2023 Accepting new patients
Mercy Hospital Carthage Current Accepting new patients
Sgoh Acquisition Inc Past Accepting new patients

Locations

1101 Jackson St SW
Gravette, AR 72736
Phone (479) 787-5221

3116 Medical Park Dr
Carthage, MO 64836
Phone (417) 358-7574

3125 Dr Russell Smith Way
Carthage, MO 64836
Phone (417) 358-8121

1717 S Range Line Rd
Ste B
Joplin, MO 64804
Phone (417) 556-2231

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1861753709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 MEDICAL CENTER PKWY STE 110",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123212",
            "telephone_number": "479-715-4262",
            "fax_number": "866-817-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 MEDICAL CENTER PKWY STE 110",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123212",
            "telephone_number": "479-715-4262",
            "fax_number": "866-817-7601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3125 Dr Russell Smith Way",
            "address_purpose": "LOCATION",
            "city": "Carthage",
            "state": "MO",
            "postal_code": "648367402",
            "country_code": "US",
            "telephone_number": "501-821-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMP",
        "first_name": "NICHOLAS",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-07",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MO",
            "license": "2017004412",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AR",
            "license": "E-10371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.