NPIMap

Organization Active NPI

Community Pain Consultants, LTD

  • Specialist
  • Kankakee, IL
National Provider Identifier
1053623801
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036065101 Issued in IL
Legal business name
COMMUNITY PAIN CONSULTANTS, LTD
Practice address
555 W Court St
Suite 100
Kankakee, IL 60901-3664
Phone
(815) 932-7246
Fax
(815) 932-7307
NPI assigned
Jul 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Authorized official

Name
Dr. James Michael Kelly, M.D.NPI 1881679553
Title
Owner
Phone
(815) 932-7146

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 036065101 IL Primary

Addresses

Primary practice location

555 W Court St
Suite 100
Kankakee, IL 60901-3664

Mailing address

555 W Court St
Suite 100
Kankakee, IL 60901-3664
Phone (815) 932-7246

National Provider Directory

National Provider Directory

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": "1278633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1053623801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W COURT ST",
            "address_2": "SUITE 100",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013664",
            "telephone_number": "815-932-7246",
            "fax_number": "815-932-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W COURT ST",
            "address_2": "SUITE 100",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013664",
            "telephone_number": "815-932-7246",
            "fax_number": "815-932-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PAIN CONSULTANTS, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-09",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-932-7146",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036065101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.