NPIMap

Organization Active NPI

Advanced Pain Medicine Associates, LLC

  • Specialist
  • Wichita, KS
National Provider Identifier
1083982037
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ADVANCED PAIN MEDICINE ASSOCIATES, LLC
Practice address
3715 N Oliver
Wichita, KS 67220-3404
Phone
(316) 942-4519
Fax
(316) 942-4655
NPI assigned
Dec 6, 2011
Last updated
Nov 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Authorized official

Name
Dr. Jon C Parks, M.DNPI 1477544658
Title
President
Phone
(316) 942-4519

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
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X Primary
Pain Clinic/Center 261QP3300X
Physiological Laboratory 293D00000X KS

Addresses

Primary practice location

3715 N Oliver
Wichita, KS 67220-3404

Mailing address

3715 N Oliver
Wichita, KS 67220-3404
Phone (316) 942-4519

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111205000803 KS Part B Supplier - Clinic/Group Practice 7113192063 Receives reassigned benefits from 16 practitioners
Practice locations: Wichita, KS

National Provider Directory

National Provider Directory

Locations

3715 N Oliver St
Wichita, KS 67220
Phone (316) 440-1276

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1323129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668124800000",
    "number": "1083982037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 N OLIVER",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672203404",
            "telephone_number": "316-942-4519",
            "fax_number": "316-942-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 N OLIVER",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672203404",
            "telephone_number": "316-942-4519",
            "fax_number": "316-942-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PAIN MEDICINE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-06",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "316-942-4519",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "KS",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.