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 Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 111NR0400X | Chiropractor | Rehabilitation | | | No |
| 2 | 207LP2900X | Anesthesiology | Pain Medicine | | | No |
| 3 | 2084B0040X | Psychiatry & Neurology | Behavioral Neurology & Neuropsychiatry | | | No |
| 4 | 208VP0000X | Pain Medicine | Pain Medicine | | | No |
| 5 | 225100000X | Physical Therapist | | | | No |
| 6 | 363LA2100X | Nurse Practitioner | Acute Care | | | No |
| 7 | 208VP0014X | Pain Medicine | Interventional Pain Medicine | | | Yes |