PAIN CENTER LLC NPI 1578643607

NPI Information

  • NPI: 1578643607
  • Provider Name: PAIN CENTER LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Address: 505 E MATTHEWS AVE
    SUITE 103
    JONESBORO, AR
    ZIP 72401
  • Phone: (870) 972-0411

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NPI Details

PAIN CENTER LLC is an ambulatory surgical clinic center in Jonesboro, AR. PAIN CENTER LLC NPI is 1578643607. The provider is registered as an organization entity type.

The provider's business location address is:

505 E MATTHEWS AVE
SUITE 103
JONESBORO, AR
ZIP 72401-144
Phone: (870) 972-0411
Fax: (870) 933-8011

The provider's authorized official is Monica R Formon .
The authorized official title is Administrator and has the following contact phone number (870) 972-0411.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection of lower or sacral spine facet joint using imaging guidance, single level (HCPCS:64493)
  • Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint (HCPCS:64635)
  • Injection of upper or middle spine facet joint using imaging guidance, single level (HCPCS:64490)
  • Injection of anesthetic agent into middle or lower spine sympathetic nerve (HCPCS:64520)
  • Injection of substance into lower spine canal using imaging guidance (HCPCS:62323)
  • Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint (HCPCS:64633)
  • Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level (HCPCS:64483)

The enumeration date for this NPI number is 10/16/2006 and was last updated on 11/10/2010.

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
1261QA1903XClinic/CenterAmbulatory SurgicalAR4148ARKANSASYes

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 Other Provider Identifier Issuer
111000OTHERARKANSASBLUE CROSS PROVIDER NUMBE
211000MEDICARE ID-TYPE UNSPECIFIEDARKANSASPROVIDER NUMBER
30213069OTHERARKANSASDEPT OF LABOR WA
4150029128MEDICAIDARKANSAS

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: 3/30/2025

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