BENTONVILLE AMBULATORY SURGERY CENTER, LLC (NPI# 1427662345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427662345 |
| Entity Type | Organization |
| Organization Name | BENTONVILLE AMBULATORY SURGERY CENTER, LLC |
| Practice Address |
2902 We Mid-cities Dr Bentonville AR 72712 |
| Mailing Address |
108 N Shackleford Rd Little Rock AR 72211-2840 |
| Practice Telephone | 8442150731 |
| Practice Fax Number | 8886308885 |
| Mailing Telephone | 5077736993 |
| Mailing Fax Number | 8886308885 |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2020-09-10 |
| Authorized Official Name | MRS. EILIZABETH ANN WADDELL (ASC ADMINISTRATOR) |
| Authorized Official Telephone | 5017661065 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
2902 WE MID-CITIES DR |
| City | BENTONVILLE |
| State | AR |
| Zip Code | 72712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942837059 | Amy Crumpton | Counselor | 3504 Se Riveria Road, Bentonville, AR 72712 | 2020-03-26 |
| 1295361509 | Unbridled Holdings LLC | Physical Therapy Assistant | 9900 Price Coffee Rd, Bentonville, AR 72712 | 2020-03-18 |
| 1649803552 | Hanna Kathryn Baxendale | Pediatrics | 2900 Medical Pkwy, Ste #370, Bentonville, AR 72712 | 2020-02-19 |
| 1740746635 | Meredith C Hodges | Counselor | 2508 Se 2oth St, Bentonville, AR 72712 | 2019-02-15 |
| 1609352566 | Tripharma Inc | Pharmacy | 3500 Sw Regional Airport Blvd Ste 2, Bentonville, AR 72712 | 2018-07-13 |
| 1811406747 | Upspring Therapy, LLC | Counselor | 2106 Sw Walton Blvd, Suite B, Bentonville, AR 72712 | 2017-09-22 |
| 1023536836 | Charlotte Yuvonne Hoyle | Case Manager/Care Coordinator | 2005 S.e Walton Blvd., Bentonville, AR 72712 | 2017-08-31 |
| 1508399502 | Rosanna Nicole Rephan | Nurse Practitioner | 3101 14th St, Mercy Convenient Care, Bentonville, AR 72712 | 2017-04-06 |
| 1417305517 | Charlotte Lennette Stephenson | Behavioral Analyst | 2005 S.e. Walton Blvd., Bentonville, AR 72712 | 2016-05-31 |
| 1740649920 | Patricia Ellen Sheppard | Nurse Practitioner | 3400 Se Macy, Bentonville, AR 72712 | 2016-02-17 |
| Find all providers in zip 72712 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932619327 | Fort Neuro | Pain Medicine | 1501 S Waldron Rd Ste 109, Fort Smith, AR 72903-2568 | 2017-10-11 |
| 1891061040 | Vadim Petrov-kondratov | Pain Medicine | 180 Medical Park Pl Ste 102, Hot Springs, AR 71901-8066 | 2012-03-31 |
| 1356635486 | Mohamed Tolba | Pain Medicine | 1080 Pats Ln, Conway, AR 72032-4754 | 2011-06-06 |
| 1295032407 | Interventional Pain Specialists of Nwa, Pllc | Pain Medicine | 509 E Millsap Rd Ste 109, Fayetteville, AR 72703-4862 | 2011-02-24 |
| 1376733824 | Hot Springs Interventional Pain Management | Pain Medicine | 1 Mercy Ln Ste 304, Hot Springs, AR 71913 | 2007-07-31 |
| 1558447599 | White River Health System, Inc. | Pain Medicine | 1700 Harrison St Ste T, Batesville, AR 72501-7315 | 2006-10-31 |
| 1699781427 | Sunil Gera | Pain Medicine | 2601 Southwest Square, Jonesboro, AR 72401 | 2006-08-01 |
| 1104806702 | Robert David Cannon | Pain Medicine | 3715 N Business Dr, Suite #101, Fayetteville, AR 72703-5204 | 2006-01-19 |
| 1386641520 | Sunder Krishnan | Pain Medicine | 14918 Cantrell Rd, Little Rock, AR 72223-4248 | 2005-07-01 |
| 1568465698 | Donald L Boos Jr. | Pain Medicine | 307 Carpenter Dam Rd Ste F, Hot Springs, AR 71901-8282 | 2005-05-23 |
| Find all providers with the same taxonomy | ||||
| City | BENTONVILLE |
| Zip Code | 72712 |
Please comment or provide details below to improve the information on BENTONVILLE AMBULATORY SURGERY CENTER, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.