NPIMap

Organization Active NPI

Premier Pain Treatment Institute, LLC

  • Interventional Pain Medicine Physician
  • Mount Orab, OH
National Provider Identifier
1043775752
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
PREMIER PAIN TREATMENT INSTITUTE, LLC
Practice address
111 Vandament Way
Mount Orab, OH 45154-8395
Phone
(513) 454-7246
NPI assigned
Feb 6, 2019
Organization subpart
Yes
Parent organization
PREMIER PAIN TREATMENT INSTITUTE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Authorized official

Name
Michael Donald DankoNPI 1861654048
Title
MD/Ceo
Phone
(513) 454-7246

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X Primary
Durable Medical Equipment & Medical Supplies 332B00000X
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

111 Vandament Way
Mount Orab, OH 45154-8395

Mailing address

PO Box 330
Loveland, OH 45140-0330
Phone (513) 454-7246

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190409002555 OH DME Supplier - Physician - Interventional Pain ManagementDME Supplier - Nurse Practitioner 5092019281 Practice locations: Mount Orab, OH

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Premier Pain Treatment Institute2 organizations share this tax ID, including this one
Part of
Premier Pain Treatment Institute

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1043775752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 330",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451400330",
            "telephone_number": "513-454-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 VANDAMENT WAY",
            "city": "MOUNT ORAB",
            "state": "OH",
            "postal_code": "451548395",
            "telephone_number": "513-454-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PAIN TREATMENT INSTITUTE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER PAIN TREATMENT INSTITUTE, LLC",
        "enumeration_date": "2019-02-06",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "DANKO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "MD/CEO",
        "authorized_official_telephone_number": "513-454-7246"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Orab, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.