JARED ENNIS (NPI# 1467539155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467539155 |
| Entity Type | Individual |
| Full Name | JARED ENNIS |
| Credential | MD |
| Practice Address |
4019 N Remington Dr Fayetteville AR 72703-6344 |
| Practice Telephone | 4795958192 |
| Practice Fax Number | 4794421748 |
| Mailing Telephone | 4795958192 |
| Mailing Fax Number | 4794421748 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2017-01-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | E-4271 | AR | Allopathic & Osteopathic Physicians |
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
E-4271 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 157891001 | 05 |
| Street Address |
4019 N REMINGTON DR |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72703-6344 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932328267 | Jason Holt | Anesthesiology | 4019 N Remington Dr, Fayetteville, AR 72703-6344 | 2007-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154391 | Margaret Sorrells | Pharmacist | 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 | 2020-11-06 |
| 1497369631 | Justin A Rand | Massage Therapist | 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 | 2020-09-04 |
| 1235777558 | Washington Regional Medical System | Specialist | 3264 N North Hills Blvd, Fayetteville, AR 72703 | 2019-12-17 |
| 1760024582 | Haley Brooke Thompson | Occupational Therapist | 2474 E Joyce Blvd Ste 2, Null, Fayetteville, AR 72703 | 2019-10-14 |
| 1306492129 | Bhg L, LLC | Clinic/Center | 8 Colt Square Drive, Fayetteville, AR 72703 | 2019-08-16 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1821574815 | Toni Myer | Nurse Practitioner | 3 E Appleby Rd Ste 101, Fayetteville, AR 72703 | 2018-07-13 |
| 1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
| 1649726449 | Vantage Point of Nwa | Community/Behavioral Health | 4171 N. Crossover Rd, Fayetteville, AR 72703 | 2016-08-31 |
| 1386097137 | Jason Nordstrom | Speech-Language Pathologist | 2664 N Valencia Ave, Fayetteville, AR 72703 | 2016-07-18 |
| Find all providers in zip 72703 | ||||
| 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 |
|---|---|---|---|---|
| 1578193355 | Regenerative Spine and Pain Specialists | Pain Medicine | 874 Lanier Ave W Ste 250, Fayetteville, GA 30214-7662 | 2020-01-22 |
| 1295032407 | Interventional Pain Specialists of Nwa, Pllc | Pain Medicine | 509 E Millsap Rd Ste 109, Fayetteville, AR 72703-4862 | 2011-02-24 |
| 1063628675 | Southside Medical & Physical Therapy, LLC | Pain Medicine | 1415 Highway 85 N, Suite 310-314, Fayetteville, GA 30214-4035 | 2007-05-14 |
| 1104806702 | Robert David Cannon | Pain Medicine | 3715 N Business Dr, Suite #101, Fayetteville, AR 72703-5204 | 2006-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427662345 | Bentonville Ambulatory Surgery Center, LLC | Pain Medicine | 2902 We Mid-cities Dr, Bentonville, AR 72712 | 2020-09-08 |
| 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 |
| 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 |
| 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 |
| 1104306919 | Comprehensive Pain Care Pa | Pain Medicine | 201 N Slemons St, Monticello, AR 71655-4326 | 2018-08-21 |
| Find all providers with the same taxonomy | ||||
| City | FAYETTEVILLE |
| Zip Code | 72703 |
Please comment or provide details below to improve the information on JARED ENNIS.
| 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.