Organization Active NPI

Precision Pain Treatment Clinic LLC

  • Pain Medicine Physician
  • Smithfield, RI
National Provider Identifier
1033523063
Registry record updated Sep 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
PRECISION PAIN TREATMENT CLINIC LLC
Practice address
14 Cedar Swamp Rd
Smithfield, RI 02917-2448
Phone
(401) 231-0060
Fax
(401) 231-0064
NPI assigned
Jun 18, 2014
Last updated
Sep 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Authorized official

Name
Keith Perry, MDNPI 1548214141
Title
MD
Phone
(401) 231-0060

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
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

14 Cedar Swamp Rd
Smithfield, RI 02917-2448

Mailing address

14 Cedar Swamp Rd
Smithfield, RI 02917-2448
Phone (401) 231-0060

Other identifiers 1

IdentifierTypeStateIssuer
1548214141OtherRIINDIVIDUAL NPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140930001952 RI Part B Supplier - Clinic/Group Practice 3870713639 Receives reassigned benefits from 1 practitioner
Practice locations: Smithfield, RI

National Provider Directory

National Provider Directory

Locations

14 Cedar Swamp Rd
Smithfield, RI 02917
Phone (401) 228-7585

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409702400000",
    "number": "1033523063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 CEDAR SWAMP RD",
            "city": "SMITHFIELD",
            "state": "RI",
            "postal_code": "029172448",
            "telephone_number": "401-231-0060",
            "fax_number": "401-231-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 CEDAR SWAMP RD",
            "city": "SMITHFIELD",
            "state": "RI",
            "postal_code": "029172448",
            "telephone_number": "401-231-0060",
            "fax_number": "401-231-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION PAIN TREATMENT CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-18",
        "last_updated": "2014-09-03",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "401-231-0060",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1548214141",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; 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.