Eastern Kentucky Pain Management Center LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

EASTERN KENTUCKY PAIN MANAGEMENT CENTER LLC

Practice address

1694 Northgate Dr
Richmond, KY 40475-1066

Phone

(859) 626-7755

Fax

(859) 626-7766

NPI assigned

Oct 21, 2009

Last updated

May 26, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brad Hamblen

Title

Member

Phone

(859) 746-2444

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306368000000",
    "number": "1053647313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1694 NORTHGATE DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404751066",
            "telephone_number": "859-626-7755",
            "fax_number": "859-626-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1694 NORTHGATE DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404751066",
            "telephone_number": "859-626-7755",
            "fax_number": "859-626-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN KENTUCKY PAIN MANAGEMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-21",
        "last_updated": "2011-05-26",
        "status": "A",
        "authorized_official_last_name": "HAMBLEN",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "859-746-2444"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100095660",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Marie Durrum, M.A.
• Brandi Hunley Dyer, M.D.
• E.W. James & Sons #56
• Jamie Easter, OTR/L
• Eastern Kentucky Medical Services
• David L Eastham Jr., MA
• Ava Marie Eaves, R.D.,C.D.E.
• Ebb and Flow Co (Ebb & Flow Massage Therapy)
• Shawnda Lucia Ebert, LAT, ATC
• Cathy Lynne Edwards, R.PH.

• Physical Medicine & Rehabilitation Physician in Richmond, KY
• Providers in Richmond, KY by specialty
• Physical Medicine & Rehabilitation Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.