ADVANCED SPINE AND PAIN LLC NPI 1629679923

NPI Information

  • NPI: 1629679923
  • Provider Name: ADVANCED SPINE AND PAIN LLC
  • Classification: Physical Medicine & Rehabilitation - 2081P2900X
  • Specialization: Pain Medicine
  • Entity Type: Organization
  • Address: 4566 E INVERNESS AVE STE 205
    MESA, AZ
    ZIP 85206
  • Phone: (480) 640-0513

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NPI Details

ADVANCED SPINE AND PAIN LLC is a pain medicine physical medicine rehabilitation in Mesa, AZ. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. ADVANCED SPINE AND PAIN LLC NPI is 1629679923. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4566 E INVERNESS AVE STE 205
MESA, AZ
ZIP 85206-634
Phone: (480) 640-0513

The provider's authorized official is Jarrett Michael Leathem .
The authorized official title is Md, Owner and has the following contact phone number (860) 670-2412.

The enumeration date for this NPI number is 11/3/2020 and was last updated on 1/20/2021.

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
1208VP0000XPain MedicinePain MedicineNo
2208VP0014XPain MedicineInterventional Pain MedicineNo
3207LP2900XAnesthesiologyPain MedicineNo
4363A00000XPhysician AssistantNo
5363L00000XNurse PractitionerNo
62081P2900XPhysical Medicine & RehabilitationPain MedicineYes

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: 3/30/2025

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