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PRESTIGE SPINE INTERVENTIONAL PAIN MANAGEMENT, LLC
NPI 1265044119
Pain Medicine - Interventional Pain Medicine in Conway, AR

Active since August 21, 2020CLIA 04D2204445 · Waiver
650 UNITED DR STE 340, CONWAY, AR 72032(501) 358-6791 Get Directions Write a Review

NPPES record last updated: August 23, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 23, 2022, Dec 16, 2020, Aug 21, 2020 (3 updates tracked since 2020).

About Prestige Spine Interventional Pain Management, Llc NPPES

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

PRESTIGE SPINE INTERVENTIONAL PAIN MANAGEMENT, LLC (NPI 1265044119) is a healthcare organization registered as an interventional pain medicine in Conway, Arkansas and active in the NPI registry since August 2020. The organization holds a CLIA Waiver certificate valid through December 8, 2026 and lists April Johnson, Member, as its authorized official.

NPPES Registry Identity

NPI1265044119
Entity TypeOrganization
Primary Taxonomy208VP0014X
Legal Business NamePRESTIGE SPINE INTERVENTIONAL PAIN MANAGEMENT, LLC
Location Address650 UNITED DR STE 340Conway, AR 72032-7826
Mailing Address650 United Dr Ste 340Conway, AR 72032-7826 · (501) 993-8300
Phone(501) 358-6791
Organization SubpartNo
Authorized OfficialApril JohnsonMember · (501) 993-8300
Enumeration DateAugust 21, 2020
Last NPPES UpdateAugust 23, 20223 updates tracked since enumeration
NPPES CertifiedAugust 23, 2022
✔ NPI 1265044119 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0014X
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.
Also ListedClinic/Center · PainTaxonomy 261QP3300X
650 UNITED DR STE 340, Conway, AR 72032
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

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 Waiver 04D2204445

Prestige Spine Interventional Pain Management LLC · Conway, AR
Active · expires Dec 8, 2026
CLIA Number04D2204445
Laboratory TypePhysician Office
Certificate Effective DateDecember 9, 2024
Certificate Expiration DateDecember 8, 2026
Laboratory DirectorDr. Daniel T. Judkins
Laboratory Phone(501) 358-6791
Laboratory LocationPrestige Spine Interventional Pain Management LLC650 United Dr Suite 340, Conway, AR 72032
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

KAYLA RICHARDSON
Nurse Practitioner (Family)
650 UNITED DR STE 340
CONWAY, AR 72032
Faulkner County (501) 358-6791
DR. DANIEL THORNTON JUDKINS M.D.
Anesthesiology (Pain Medicine)
650 UNITED DR STE 340
CONWAY, AR 72032
Faulkner County (501) 358-6791
SHEFFIELD KENT M.D.
Anesthesiology (Pain Medicine)
650 UNITED DR STE 340
CONWAY, AR 72032
Faulkner County (501) 358-6791
ARKANSAS HEALTH GROUP
Anesthesiology (Pain Medicine)
650 UNITED DR STE 340
CONWAY, AR 72032
Faulkner County (501) 358-6791

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 Prestige Spine Interventional Pain Management, LLC's NPI number?

The NPI number for Prestige Spine Interventional Pain Management, LLC is 1265044119. It was assigned to this organization in the NPPES registry on August 21, 2020.

Where is Prestige Spine Interventional Pain Management, LLC located?

Prestige Spine Interventional Pain Management, LLC is located at 650 United Dr Ste 340, Conway, AR 72032. The listed phone number is (501) 358-6791.

What is Prestige Spine Interventional Pain Management, LLC's specialty?

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

Does Prestige Spine Interventional Pain Management, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D2204445) is associated with this NPI, valid through December 8, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Prestige Spine Interventional Pain Management, LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 other insurers list Prestige Spine Interventional Pain Management, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Prestige Spine Interventional Pain Management, LLC was last updated on August 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.