Organization Active NPI

Dauntless TMS PLLC

  • Psychiatry Physician
  • Fayetteville, AR
National Provider Identifier
1942970884
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
DAUNTLESS TMS PLLC
Practice address
2580 E Joyce Blvd Ste 2
Fayetteville, AR 72703-3924
Phone
(479) 305-7201
NPI assigned
Sep 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Authorized official

Name
Jacquelyn Lange, MD
Title
Owner
Phone
(479) 305-7201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

2580 E Joyce Blvd Ste 2
Fayetteville, AR 72703-3924

Mailing address

PO Box 8936
Fayetteville, AR 72703-0016
Phone (210) 268-9362

National Provider Directory

National Provider Directory

Locations

2580 E Joyce Blvd
Ste 2
Fayetteville, AR 72703
Phone (479) 305-7201

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1942970884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8936",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727030016",
            "telephone_number": "210-268-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 E JOYCE BLVD STE 2",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033924",
            "telephone_number": "479-305-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAUNTLESS TMS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "LANGE",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-305-7201",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.