Provider Type Icon

ADVANCED SPINE AND PAIN LLC NPI 1659030005


NPI Information

NPI: 1659030005
Provider Name: ADVANCED SPINE AND PAIN LLC
Classification: Pain Medicine - 208VP0014X
Entity Type: Organization

Specialization: Interventional Pain Medicine

CLIA Number: 03D2247240

Address:
15571 N REEMS RD BLDG D
SURPRISE, AZ
ZIP 85374
Phone: (480) 573-0130
Get Directions

ADVANCED SPINE AND PAIN LLC is an interventional pain medicine pain medicine in Surprise, AZ. 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. ADVANCED SPINE AND PAIN LLC NPI is 1659030005. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

15571 N REEMS RD BLDG D
SURPRISE, AZ
ZIP 85374-584
Phone: (480) 573-0130

The provider's authorized official is Jarrett Michael Leathem .
The authorized official title is Do, Owner and has the following contact phone number (480) 573-0130.

The CLIA number assigned to this NPI record is 03D2247240 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/14/2021 and was last updated on 12/14/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractorNo
2207L00000XAnesthesiologyNo
3207LP2900XAnesthesiologyPain MedicineNo
4207X00000XOrthopaedic SurgeryNo
52081P2900XPhysical Medicine & RehabilitationPain MedicineNo
6208VP0000XPain MedicinePain MedicineNo
7208VP0014XPain MedicineInterventional Pain MedicineYes
8363A00000XPhysician AssistantNo
9363L00000XNurse PractitionerNo

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.