NPIMap

Organization Active NPI

Southwest Spine and Pain Care Specialists, LLC

Doing business as Physicians Laboratory Services

  • Clinical Medical Laboratory
  • St George, UT
National Provider Identifier
1003441858
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
SOUTHWEST SPINE AND PAIN CARE SPECIALISTS, LLC
Doing business as
Physicians Laboratory Services
Practice address
2051 E Red Hills Pkwy Ste 7
St George, UT 84770-8671
Phone
(435) 703-2930
Fax
(435) 703-2933
NPI assigned
Mar 11, 2020
Last updated
Mar 11, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHWEST SPINE AND PAIN CARE SPECIALISTS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Derek Lee Frieden, MDNPI 1528059201
Title
Managing Partner
Phone
(435) 656-2424

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

2051 E Red Hills Pkwy Ste 7
St George, UT 84770-8671

Mailing address

652 S Medical Center Dr Ste 110
St George, UT 84790-7077
Phone (435) 656-2424

Other names 1

  • Physicians Laboratory Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
SW Spine and Pain Care SPC2 organizations share this tax ID, including this one
Part of
SW Spine and Pain Care SPC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583884800000",
    "number": "1003441858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 S MEDICAL CENTER DR STE 110",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907077",
            "telephone_number": "435-656-2424",
            "fax_number": "435-986-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 E RED HILLS PKWY STE 7",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847708671",
            "telephone_number": "435-703-2930",
            "fax_number": "435-703-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SPINE AND PAIN CARE SPECIALISTS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHWEST SPINE AND PAIN CARE SPECIALISTS, LLC",
        "enumeration_date": "2020-03-11",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A",
        "authorized_official_last_name": "FRIEDEN",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "435-656-2424",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Laboratory Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.