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MIDWEST PAIN CLINIC PC NPI 1043482094


NPI Information

NPI: 1043482094
Provider Name: MIDWEST PAIN CLINIC PC
Classification: Pain Medicine - 208VP0014X
Entity Type: Organization

Specialization: Interventional Pain Medicine

CLIA Number: 16D2269500

Address:
825 N 90TH ST
OMAHA, NE
ZIP 68114
Phone: (402) 391-7246
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MIDWEST PAIN CLINIC PC is an interventional pain medicine pain medicine in Omaha, NE. The provider is 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. MIDWEST PAIN CLINIC PC NPI is 1043482094. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

825 N 90TH ST
OMAHA, NE
ZIP 68114-702
Phone: (402) 391-7246
Fax: (402) 408-1783

The provider's authorized official is Maureen E Mahoney .
The authorized official title is Credentialing Specialist and has the following contact phone number (402) 391-7246.

The CLIA number assigned to this NPI record is 16D2269500 - independent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/31/2008 and was last updated on 9/12/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207LP2900XAnesthesiologyPain MedicineNo
22081P2900XPhysical Medicine & RehabilitationPain MedicineNo
3208VP0000XPain MedicinePain MedicineNo
4363A00000XPhysician AssistantNo
5363LF0000XNurse PractitionerFamilyNo
6208VP0014XPain MedicineInterventional Pain MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1263940MEDICAIDIOWA
2S104099MEDICAIDSOUTH DAKOTA
3NA1054MEDICAIDNEBRASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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