NPIMap

Organization Active NPI

Interwest Comprehensive Pain Center

  • Pain Medicine (Anesthesiology) Physician
  • Logan, UT
National Provider Identifier
1043234685
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
6006178-1205 Issued in UT
Legal business name
INTERWEST COMPREHENSIVE PAIN CENTER
Practice address
2380 N 400 E
Ste a
Logan, UT 84341-1749
Phone
(435) 713-9681
Fax
(435) 753-1201
NPI assigned
Jul 27, 2006
Last updated
Jul 11, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

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

Authorized official

Name
Dr. Peter C Daines, M.D.NPI 1033169198
Title
Manager
Phone
(435) 753-1600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 6006178-1205 UT Primary

Addresses

Primary practice location

2380 N 400 E
Ste a
Logan, UT 84341-1749

Mailing address

274 N Main St
Logan, UT 84321-3915
Phone (435) 753-1600

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310342400000",
    "number": "1043234685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 N MAIN ST",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843213915",
            "telephone_number": "435-753-1600",
            "fax_number": "435-753-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 N 400 E",
            "address_2": "STE A",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843411749",
            "telephone_number": "435-713-9681",
            "fax_number": "435-753-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERWEST COMPREHENSIVE PAIN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2011-07-11",
        "status": "A",
        "authorized_official_last_name": "DAINES",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "435-753-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "UT",
            "license": "6006178-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; 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.