NPIMap

Organization Active NPI

Pain Management Medicine

  • Pain Clinic/Center
  • Lexington, KY
National Provider Identifier
1124578703
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
License
TC537 Issued in KY
Legal business name
PAIN MANAGEMENT MEDICINE
Practice address
715 Shaker Dr
Suite 132
Lexington, KY 40504-3662
Phone
(859) 275-4878
NPI assigned
Oct 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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

Authorized official

Name
Danesh Mazloomdoost, M.D.NPI 1851447072
Title
President
Phone
(859) 275-4878

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
Pain Clinic/Center 261QP3300X TC537 KY Primary

Addresses

Primary practice location

715 Shaker Dr
Suite 132
Lexington, KY 40504-3662

Mailing address

725 Shaker Driv
Suite 132
Lexington, KY 40504
Phone (859) 278-4878

National Provider Directory

National Provider Directory
Tax ID family
Pain Management Medicine3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1475798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475798400000",
    "number": "1124578703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 SHAKER DRIV",
            "address_2": "SUITE 132",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40504",
            "telephone_number": "859-278-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 SHAKER DR",
            "address_2": "SUITE 132",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043662",
            "telephone_number": "859-275-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MANAGEMENT MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-07",
        "last_updated": "2016-10-07",
        "status": "A",
        "authorized_official_last_name": "MAZLOOMDOOST",
        "authorized_official_first_name": "DANESH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-275-4878",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "KY",
            "license": "TC537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; 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.