Organization Active NPI

Camp Interventional Pain Associates, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Bentonville, AR
National Provider Identifier
1871060079
Registry record updated Oct 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
CAMP INTERVENTIONAL PAIN ASSOCIATES, PLLC
Practice address
2900 Medical Center Pkwy Ste 110
Bentonville, AR 72712-3212
Phone
(501) 913-3879
NPI assigned
Oct 26, 2018
Last updated
Oct 26, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2018

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

Authorized official

Name
Brittany Camp
Title
Office Manager
Phone
(501) 913-3879

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X 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 (501) 913-3879

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181204000291 AR Part B Supplier - Clinic/Group Practice 9537403407 Receives reassigned benefits from 2 practitioners
Practice locations: Bentonville, AR

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2241332Camp Interventional Pain Associates2900 Medical Center Pkwy, Suite 110, Bentonville, AR 72712Certificate of waiverOct 26, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18804/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1540512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540512000000",
    "number": "1871060079",
    "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": "501-913-3879"
        },
        {
            "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": "501-913-3879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMP INTERVENTIONAL PAIN ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-26",
        "last_updated": "2018-10-26",
        "status": "A",
        "authorized_official_last_name": "CAMP",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "501-913-3879"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.