MR. JOHNNY ROSS PAINE D.O NPI 1295708428

NPI Information

NPI: 1295708428
Provider Name: MR. JOHNNY ROSS PAINE, D.O
Classification: Family Medicine - 207QA0505X
Entity Type: Individual

Specialization: Adult Medicine

PECOS Registration: Yes

Address:
710 A DEWITT-HENRY DRIVE
BEEBE, AR
ZIP 72012
Phone: (972) 533-1767
Get Directions

MR. Johnny Ross Paine, D.O is an adult medicine family medicine in Beebe, AR. The provider is definition to come. MR. Johnny Ross Paine, D.O NPI is 1295708428. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

710 A DEWITT-HENRY DRIVE
BEEBE, AR
ZIP 72012
Phone: (972) 533-1767
Fax: (501) 279-1217

The NPI 1295708428 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/8/2006 and was last updated on 5/18/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0505X	Family Medicine	Adult Medicine	3902	OKLAHOMA	No
2	207Q00000X	Family Medicine		L4621	TEXAS	No
3	207QA0505X	Family Medicine	Adult Medicine	R-3454	ARKANSAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	197838901	MEDICAID	TEXAS
2	53931	MEDICARE ID-TYPE UNSPECIFIED	OKLAHOMA
3	1203902	MEDICAID	OKLAHOMA
4	8L4416	MEDICARE PIN	TEXAS
5	103756003	MEDICAID	ARKANSAS
6	197838902	MEDICAID	TEXAS
7	323068YJX8	MEDICARE PIN	ARKANSAS
8	D17031	MEDICARE UPIN	ARKANSAS
9	8L4425	MEDICARE PIN	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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