Danville Interventional Pain

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

DANVILLE INTERVENTIONAL PAIN

Practice address

300 West Broadway
Danville, KY 40422

Phone

(859) 236-9203

Fax

(859) 236-6754

NPI assigned

Jun 3, 2006

Last updated

Aug 22, 2020By 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

Mr. Khursheed Siddiqui, MDNPI 1881634368

Title

President

Phone

(859) 236-9203

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Khursheed A Siddiqui, MD

  • Pain Medicine Physician
  • Danville, KY
  • NPI 1881634368
  NPD (past) Authorized official

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093753683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95267",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WEST BROADWAY",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "40422",
            "telephone_number": "859-236-9203",
            "fax_number": "859-236-6754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANVILLE INTERVENTIONAL PAIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "KHURSHEED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-236-9203",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65942906",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD1588",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danville Drug Company (Danville Drug Company, LLC)
• Danville Eye Center, PLLC
• Danville Family Chiropractic 2019 PLLC
• Danville Family Dre LLC
• Danville Independent Schools
• Danville Medical Practice PLLC
• Danville Medical Specialists
• Danville Medical Specialty
• Danville Nephrology Consultants
• Danville Orthopaedics & Sports Medicine, PSC

• Pain Medicine (Anesthesiology) Physician in Danville, KY
• Providers in Danville, KY by specialty
• Pain Medicine (Anesthesiology) Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.