NPIMap

Organization Active NPI

Medela Vida LLC

  • Pain Clinic/Center
  • Mesa, AZ
National Provider Identifier
1073124509
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
MEDELA VIDA LLC
Practice address
6020 E Brown Rd Ste 104
Mesa, AZ 85205-4812
Phone
(602) 428-0700
NPI assigned
Aug 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Authorized official

Name
Timothy Dean BinghamNPI 1831708338
Title
Owner
Phone
(480) 331-0046

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 Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

6020 E Brown Rd Ste 104
Mesa, AZ 85205-4812

Mailing address

6020 E Brown Rd Ste 104
Mesa, AZ 85205-4812
Phone (602) 428-0700

Other names 1

  • PIBCOA - The Pain, Injury & Brain Centers of America Doing business as

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.

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597017600000",
    "number": "1073124509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 E BROWN RD STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054812",
            "telephone_number": "602-428-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 E BROWN RD STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054812",
            "telephone_number": "602-428-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDELA VIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A",
        "authorized_official_last_name": "BINGHAM",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-331-0046"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PIBCOA - The Pain, Injury & Brain Centers of America",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.