NPIMap

Organization Active NPI

Lake of the Ozarks Pain Management Services, Inc

  • Specialist
  • Osage Beach, MO
National Provider Identifier
1003901976
Registry record updated May 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
LAKE OF THE OZARKS PAIN MANAGEMENT SERVICES, INC
Practice address
54 Hospital Dr
Osage Beach, MO 65065-3050
Phone
(573) 302-1661
NPI assigned
Oct 4, 2006
Last updated
May 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2012

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

Authorized official

Name
Alan W Mead, MDNPI 1205800117
Title
Owner
Phone
(573) 302-1661

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

54 Hospital Dr
Osage Beach, MO 65065-3050

Mailing address

5151 Osage Beach Pkwy Ste F
PO Box 840
Osage Beach, MO 65065-3285
Phone (573) 302-1661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041013000118 MO Part B Supplier - Clinic/Group Practice 0547220774 Receives reassigned benefits from 1 practitioner
Practice locations: Osage Beach, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 42

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 42

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337904000000",
    "number": "1003901976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 OSAGE BEACH PKWY STE F",
            "address_2": "PO BOX 840",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653285",
            "telephone_number": "573-302-1661",
            "fax_number": "573-302-1719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 HOSPITAL DR",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653050",
            "telephone_number": "573-302-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE OF THE OZARKS PAIN MANAGEMENT SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2012-05-25",
        "status": "A",
        "authorized_official_last_name": "MEAD",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-302-1661",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Osage Beach, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.