RDK Pain Management LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

02000860A Issued in IN

Legal business name

RDK PAIN MANAGEMENT LLC

Practice address

2580 Charlestown Rd
New Albany, IN 47150-2555

Phone

(812) 941-8635

Fax

(812) 941-8630

NPI assigned

Dec 3, 2012

Organization subpart

No

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

Authorized official

Name

Rickey D. Kinzey, D.O.

Title

Sole Member/Owner

Phone

(812) 941-8635

Specialties & licenses 2

Addresses

Other identifiers 3

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1033454012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 CHARLESTOWN RD",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471502555",
            "fax_number": "812-941-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 CHARLESTOWN RD",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471502555",
            "telephone_number": "812-941-8635",
            "fax_number": "812-941-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RDK PAIN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-03",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "KINZEY",
        "authorized_official_first_name": "RICKEY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "SOLE MEMBER/OWNER",
        "authorized_official_telephone_number": "812-941-8635",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IN",
            "license": "02000860A",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100446040",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RKA ANTHEM",
            "identifier": "000000368855",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RKP ANTHEM",
            "identifier": "000000368845",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Logan Chaz Rauck, DPT
• Roneka Leantrice Ravenell, MD
• Brooke Elyse Raymer, APRN
• Lindsey Raymer, RBT
• Syed T Raza, MD
• Ashley Reader, D.O.
• Amanda Receveur, PHARMD
• Rachel Receveur, CCC-SLP
• Ronald L Receveur, DDS
• Kristin Marie Reed, OTR/L

• Pain Medicine (Anesthesiology) Physician in New Albany, IN
• Providers in New Albany, IN by specialty
• Pain Medicine (Anesthesiology) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.