NPIMap

Organization Active NPI

Adirondack Pain Management, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Utica, NY
National Provider Identifier
1104899756
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
180710 Issued in NY
Legal business name
ADIRONDACK PAIN MANAGEMENT, PLLC
Practice address
1656 Champlin Ave
Utica, NY 13502-4830
Phone
(315) 266-0380
NPI assigned
Feb 13, 2006
Last updated
Dec 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2018

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

Authorized official

Name
Dr. Michelle M Johnston, MDNPI 1477540771
Title
Co-Owner
Phone
(315) 292-1264

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X 180710 NY Primary

Addresses

Primary practice location

1656 Champlin Ave
Utica, NY 13502-4830

Mailing address

110 Lomond CT
Utica, NY 13502-5950
Phone (315) 292-1264

Other practice location 1

110 Lomond Ct
Utica, NY 13502-5950
Phone (315) 292-1264

National Provider Directory

National Provider Directory

Locations

110 Lomond Ct
Utica, NY 13502
Phone (315) 292-1264

Practitioners & affiliated clinicians

Practitioners 3

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": "1139788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545091200000",
    "number": "1104899756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LOMOND CT",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025950",
            "telephone_number": "315-292-1264",
            "fax_number": "315-266-0385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1656 CHAMPLIN AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135024830",
            "telephone_number": "315-266-0380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Lomond Ct",
            "address_purpose": "LOCATION",
            "city": "Utica",
            "state": "NY",
            "postal_code": "135025950",
            "country_code": "US",
            "telephone_number": "315-292-1264",
            "fax_number": "315-266-0385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADIRONDACK PAIN MANAGEMENT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-13",
        "last_updated": "2018-12-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "315-292-1264",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "180710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; 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.