Organization Active NPI

Comprehensive Pain Care of South Florida LLC

  • Specialist
  • Wellington, FL
National Provider Identifier
1093993396
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME56226 Issued in FL
Legal business name
COMPREHENSIVE PAIN CARE OF SOUTH FLORIDA LLC
Practice address
2585 S State Road 7 Ste 110
Wellington, FL 33414-9438
Phone
(561) 795-8655
Fax
(561) 795-8449
NPI assigned
Feb 8, 2008
Last updated
Apr 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Authorized official

Name
Kinyata Smart
Title
Practice Administrator
Phone
(561) 795-8655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME56226 FL Primary

Addresses

Primary practice location

2585 S State Road 7 Ste 110
Wellington, FL 33414-9438

Mailing address

2585 S State Road 7 Ste 110
Wellington, FL 33414-9438
Phone (561) 795-8655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040330001484 FL Part B Supplier - Clinic/Group Practice 4082606215 Receives reassigned benefits from 7 practitioners
Practice locations: Wellington, FL
O20130118000068 FL DME Supplier - Physician - Interventional Pain Management 4082606215 Practice locations: Wellington, FL

National Provider Directory

National Provider Directory

Locations

440 N State Road 7
Ste 107
Royal Palm Beach, FL 33411
Phone (561) 795-8655

458 N State Road 7
Ste 201
Royal Palm Beach, FL 33411
Phone (561) 795-8655

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1093993396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 S STATE ROAD 7 STE 110",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334149438",
            "telephone_number": "561-795-8655",
            "fax_number": "561-795-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 S STATE ROAD 7 STE 110",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334149438",
            "telephone_number": "561-795-8655",
            "fax_number": "561-795-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE PAIN CARE OF SOUTH FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-08",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "SMART",
        "authorized_official_first_name": "KINYATA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "561-795-8655"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME56226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.