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TRI-STATE PAIN MANAGEMENT SERVICE INC NPI 1770565954


NPI Information

NPI: 1770565954
Provider Name: TRI-STATE PAIN MANAGEMENT SERVICE INC

Doing Business As: INTERVENTIONAL SPINE SPECIALISTS

Classification: Pain Medicine - 208VP0014X
Entity Type: Organization

Specialization: Interventional Pain Medicine

CLIA Number: 36D1095361

Address:
7655 FIVE MILE RD
STE 117
CINCINNATI, OH
ZIP 45230
Phone: (859) 341-7246
Get Directions

TRI-STATE PAIN MANAGEMENT SERVICE INC is an interventional pain medicine pain medicine in Cincinnati, OH. 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. TRI-STATE PAIN MANAGEMENT SERVICE INC NPI is 1770565954. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Interventional Spine Specialists.

The provider's business location address is:

7655 FIVE MILE RD
STE 117
CINCINNATI, OH
ZIP 45230
Phone: (859) 341-7246
Fax: (513) 624-0578

The provider's authorized official is Jewell Ashley .
The authorized official title is Office Manager and has the following contact phone number (513) 624-7525.

The CLIA number assigned to this NPI record is 36D1095361 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/15/2005 and was last updated on 3/24/2020.


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
1363L00000XNurse PractitionerNo
2208VP0014XPain 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
1000000388145OTHERANTHEM
25124498OTHERCIGNA
3728014OTHERBUCKEYE
42044773MEDICAIDOHIO
565944233MEDICAIDKENTUCKY
6200529320AMEDICAIDINDIANA

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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