NPIMap

Organization Active NPI

Northwest Pain Management Inc

  • Medical Specialty Clinic/Center
  • Medford, OR
National Provider Identifier
1104991405
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
12880 Issued in OR
Legal business name
NORTHWEST PAIN MANAGEMENT INC
Practice address
897 Royal Ave
Suite C
Medford, OR 97504-6121
Phone
(541) 770-1650
Fax
(541) 773-2470
NPI assigned
Nov 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Thomas John Purtzer, M.D.NPI 1366623738
Title
President
Phone
(541) 770-1650

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 12880 OR Primary

Addresses

Primary practice location

897 Royal Ave
Suite C
Medford, OR 97504-6121

Mailing address

897 Royal Ave
Suite C
Medford, OR 97504-6121
Phone (541) 770-1650

Other identifiers 2

IdentifierTypeStateIssuer
DD5160OtherORRAILROAD MEDICARE
146753MedicaidOR

Other names 1

  • Intractable Pain Centers Doing business as

National Provider Directory

National Provider Directory

Locations

897 Royal Ave
Ste C
Medford, OR 97504
Phone (541) 770-1650

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104991405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "897 ROYAL AVE",
            "address_2": "SUITE C",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046121",
            "telephone_number": "541-770-1650",
            "fax_number": "541-773-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "897 ROYAL AVE",
            "address_2": "SUITE C",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046121",
            "telephone_number": "541-770-1650",
            "fax_number": "541-773-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PAIN MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PURTZER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-770-1650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OR",
            "license": "12880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD5160",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146753",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intractable Pain Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

  • 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.