Active NPI
The Pain Institute of Southern Arizona Pisa PC
- Pain Medicine (Anesthesiology) Physician
- Safford, AZ
National Provider Identifier
1104449628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- Legal business name
- THE PAIN INSTITUTE OF SOUTHERN ARIZONA PISA PC
- Practice address
- 2241 W 16TH Street
Safford, AZ 85546 - Phone
- (520) 829-6900
- Fax
- (520) 829-6661
- NPI assigned
- May 19, 2020
- Organization subpart
- Yes
- Parent organization
- PAIN INSTITUTE OF SOUTHERN ARIZONA PISA PC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John H Cole
- Title
- Ceo
- Phone
- (520) 829-6776
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | Primary |
Addresses
Primary practice location
2241 W 16TH Street
Safford, AZ 85546
Mailing address
4881 E Grant Road
Suite 101
Tucson, AZ 85712-2704
Phone (520) 318-6035
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 954926 | Medicaid | AZ | |
| 526906 | Medicaid | AZ |
Other names 1
- Pain Institute of Southern Arizona
National Provider Directory
National Provider Directory- Part of
- Pain Institute of South Az
Locations
4881 E Grant Rd
Ste 101
Tucson, AZ 85712
Phone (520) 829-6776
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589846400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1611792000000",
"number": "1104449628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4881 E GRANT ROAD",
"address_2": "SUITE 101",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857122704",
"telephone_number": "520-318-6035",
"fax_number": "520-829-6661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2241 W 16TH STREET",
"city": "SAFFORD",
"state": "AZ",
"postal_code": "85546",
"telephone_number": "520-829-6900",
"fax_number": "520-829-6661"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE PAIN INSTITUTE OF SOUTHERN ARIZONA PISA PC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PAIN INSTITUTE OF SOUTHERN ARIZONA PISA PC",
"enumeration_date": "2020-05-19",
"last_updated": "2021-01-28",
"certification_date": "2020-08-26",
"status": "A",
"authorized_official_last_name": "COLE",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "520-829-6776"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology, Pain Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "954926",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "526906",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Pain Institute of Southern Arizona",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Pain Institute of Southern Arizona",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Safford, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.