WHITE MOUNTAIN PAIN CLINIC, PLLC — NPI 1154613586 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in SPRINGERVILLE, AZ)

CMS-1500 Box 24J / 33a • NPI

1154613586

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QP3300X

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

114 S MOUNTAIN AVE, SPRINGERVILLE, AZ, 85938-5104

✓ 9-Digit EDI 837 ZIP+4 (85938-5104)

Practice Phone & Referral Fax

(928) 333-0562

Fax: (928) 333-7157

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1154613586 (WHITE MOUNTAIN PAIN CLINIC, PLLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1154613586` (NPI-2 Organization / Facility)
Provider / Legal Name	WHITE MOUNTAIN PAIN CLINIC, PLLC
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QP3300X` (Clinic/Center, Pain)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	114 S MOUNTAIN AVE, SPRINGERVILLE, AZ, 85938-5104
Practice Telephone / Fax	Tel: (928) 333-0562 \| Fax: (928) 333-7157
Administrative Mailing Address	PO BOX 163, GREER, AZ, 85927-0163
Enumeration & Last Sync	Enumerated: 2011-05-04 \| CMS Record Updated: 2011-05-04
Authorized Official	JOHN ALLEN (CEO)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

114 S MOUNTAIN AVE, SPRINGERVILLE, AZ, 85938-5104

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Plain-English Taxonomy & CMS Crosswalk (261QP3300X)

What Does Taxonomy Code 261QP3300X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QP3300X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (WHITE MOUNTAIN PAIN CLINIC, PLLC)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261QP3300X` — Clinic/Center, Pain Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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WHITE MOUNTAIN PAIN CLINIC, PLLC (NPI #1154613586)