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NORTHEAST ARKANSAS PAIN MEDICINE
NPI 1235300765
Pain Medicine - Interventional Pain Medicine in Jonesboro, AR

Active since March 12, 2008CLIA 04D2013619 · Certificate of Compliance
505 E MATTHEWS AVE, SUITE 103, JONESBORO, AR 72401(870) 972-0411(870) 933-8011 Get Directions Write a Review

NPPES record last updated: December 15, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Northeast Arkansas Pain Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHEAST ARKANSAS PAIN MEDICINE (NPI 1235300765) is a healthcare organization registered as an interventional pain medicine in Jonesboro, Arkansas and active in the NPI registry since March 2008. The organization holds a CLIA Certificate of Compliance certificate valid through April 10, 2027 and lists Monica R Formon, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1235300765
Entity TypeOrganization
Primary Taxonomy208VP0014X
Legal Business NameNORTHEAST ARKANSAS PAIN MEDICINE
Location Address505 E MATTHEWS AVE, SUITE 103Jonesboro, AR 72401-3144
Mailing Address505 E Matthews Ave, Suite 103Jonesboro, AR 72401-3144 · (870) 972-0411 · Fax (870) 933-8011
Phone(870) 972-0411
Fax(870) 933-8011
Organization SubpartNo
Authorized OfficialMonica R FormonOffice Manager · (870) 972-0411
Enumeration DateMarch 12, 2008
Last NPPES UpdateDecember 15, 2009
✔ NPI 1235300765 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0014X
License✔ Licensed in AR · E1479
Definition
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.
505 E MATTHEWS AVE, Jonesboro, AR 72401
Open in Google Maps ↗

Other Identifiers 3

Medicare PIN5K398AR
Other5K398AR · Blue Cross
Medicaid143853002AR

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 04D2013619

Northeast Arkansas Pain Medicine, LLC · Jonesboro, AR
Active · expires Apr 10, 2027
CLIA Number04D2013619
Laboratory TypePhysician Office
Certificate Effective DateApril 11, 2025
Certificate Expiration DateApril 10, 2027
Laboratory DirectorDr. Calin A. Savu
Laboratory Phone(870) 972-0411
Laboratory LocationNortheast Arkansas Pain Medicine, LLC505 E Matthews Ave, Suite 103, Jonesboro, AR 72401
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. KERRY ANN DALTON MCD, CCC-SLP
Speech-Language Pathologist
505 E MATTHEWS AVE
JONESBORO, AR 72401
Craighead County (870) 932-9567
JEFF DENISTON PT
Specialist
505 E MATTHEWS AVE, SUITE 205
JONESBORO, AR 72401
Craighead County (870) 932-9567
MANDY LEONARD RN
Registered Nurse (Diabetes Educator)
505 E MATTHEWS AVE
JONESBORO, AR 72401
Craighead County (870) 207-7826
MR. SHON RILEY P.T.
Physical Therapist
505 E MATTHEWS AVE, SUITE 205
JONESBORO, AR 72401
Craighead County (870) 932-9567
SAMUEL B DENTON P.T.
Physical Therapist
505 E MATTHEWS AVE, STE. 205
JONESBORO, AR 72401
Craighead County (870) 932-9567
MICHELLE WINGO P.A.
Physician Assistant
505 E MATTHEWS AVE, SUITE 303
JONESBORO, AR 72401
Craighead County (870) 932-1820
GREGORY F DENTON P.T.
Physical Therapist
505 E MATTHEWS AVE, STE 205
JONESBORO, AR 72401
Craighead County (870) 932-9567
MRS. BERNICE ESTHER BROWN APRN
Nurse Practitioner (Family)
505 E MATTHEWS AVE
JONESBORO, AR 72401
Craighead County (870) 207-7500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Northeast Arkansas Pain Medicine's NPI number?

The NPI number for Northeast Arkansas Pain Medicine is 1235300765. It was assigned to this organization in the NPPES registry on March 12, 2008.

Where is Northeast Arkansas Pain Medicine located?

Northeast Arkansas Pain Medicine is located at 505 E Matthews Ave Suite 103, Jonesboro, AR 72401. The listed phone number is (870) 972-0411.

What is Northeast Arkansas Pain Medicine's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Does Northeast Arkansas Pain Medicine hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 04D2013619) is associated with this NPI, valid through April 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Northeast Arkansas Pain Medicine was last updated on December 15, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.