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ADVANCED INTERVENTIONAL PAIN MANAGEMENT PA NPI 1982669339


NPI Information

NPI: 1982669339
Provider Name: ADVANCED INTERVENTIONAL PAIN MANAGEMENT, PA
Classification: Anesthesiology - 207LP2900X
Entity Type: Organization

Specialization: Pain Medicine

Address:
160 KIMEL FOREST DR
SUITE100
WINSTON SALEM, NC
ZIP 27103
Phone: (336) 714-6400
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ADVANCED INTERVENTIONAL PAIN MANAGEMENT, PA is a pain medicine anesthesiology in Winston Salem, NC. The provider is an anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. ADVANCED INTERVENTIONAL PAIN MANAGEMENT, PA NPI is 1982669339. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

160 KIMEL FOREST DR
SUITE100
WINSTON SALEM, NC
ZIP 27103-074
Phone: (336) 714-6400
Fax: (336) 714-6402

The provider's authorized official is Johnette Carol Shultz .
The authorized official title is Cfo, Practice Administrator and has the following contact phone number (336) 714-6406.

The enumeration date for this NPI number is 4/19/2006 and was last updated on 1/6/2010.


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
1207LP2900XAnesthesiologyPain 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
1016HCOTHERNORTH CAROLINABLUE CROSS & BLUE SHIELD
289016HCMEDICAIDNORTH CAROLINA
3I915OTHERNORTH CAROLINAPARTNERS NATIONAL HEALTH
47679698OTHERNORTH CAROLINAAETNA
52342083MEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINA
6607132000OTHERNORTH CAROLINADEPT. OF LABOR

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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