NPIMap

Organization Active NPI

Prime Medical Pain Management Centers, LLC

  • Pain Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1083069694
Registry record updated May 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
PRIME MEDICAL PAIN MANAGEMENT CENTERS, LLC
Practice address
4527 N 27TH Ave
Phoenix, AZ 85017-3702
Phone
(520) 409-3445
Fax
(866) 851-4817
NPI assigned
May 2, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2016

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

Authorized official

Name
Roger H. Baker, MD
Title
Owner
Phone
(520) 409-3445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

4527 N 27TH Ave
Phoenix, AZ 85017-3702

Mailing address

4527 N 27TH Ave
Phoenix, AZ 85017-3702
Phone (520) 409-3445

National Provider Directory

National Provider Directory
Tax ID family
Prime Medical Pain Management Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462147200000",
    "number": "1083069694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4527 N 27TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850173702",
            "telephone_number": "520-409-3445",
            "fax_number": "866-851-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4527 N 27TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850173702",
            "telephone_number": "520-409-3445",
            "fax_number": "866-851-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME MEDICAL PAIN MANAGEMENT CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-02",
        "last_updated": "2016-05-02",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-409-3445",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; 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.