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PAIN MANAGEMENT CENTERS OF AMERICA PSC NPI 1891267688


NPI Information

NPI: 1891267688
Provider Name: PAIN MANAGEMENT CENTERS OF AMERICA, PSC
Classification: Pain Medicine - 208VP0014X
Entity Type: Organization

Specialization: Interventional Pain Medicine

CLIA Number: 14D1030530

Address:
108 AIRWAY DR
MARION, IL
ZIP 62959
Phone: (618) 997-7820
Get Directions

PAIN MANAGEMENT CENTERS OF AMERICA, PSC is an interventional pain medicine pain medicine in Marion, IL. 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. PAIN MANAGEMENT CENTERS OF AMERICA, PSC NPI is 1891267688. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

108 AIRWAY DR
MARION, IL
ZIP 62959-841
Phone: (618) 997-7820
Fax: (270) 554-8987

The provider's authorized official is Mahendra R. Sanapati .
The authorized official title is President and has the following contact phone number (812) 477-7246.

The CLIA number assigned to this NPI record is 14D1030530 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/18/2018 and was last updated on 4/30/2022.


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
1363LF0000XNurse PractitionerFamilyNo
22084P0800XPsychiatry & NeurologyPsychiatryNo
3332B00000XDurable Medical Equipment & Medical SuppliesNo
4208VP0014XPain 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14082761171MEDICAIDILLINOIS

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: 5/5/2024

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