NPIMap

Organization Active NPI

Northshore Interventional Pain Management

  • Non-Pharmacy Dispensing Site
  • Covington, LA
National Provider Identifier
1144734153
Registry record updated Nov 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
MD.020506 Issued in LA
Legal business name
NORTHSHORE INTERVENTIONAL PAIN MANAGEMENT
Practice address
7015 Hwy 190 E Service Rd.
Ste 101
Covington, LA 70433
Phone
(479) 636-9702
Fax
(877) 427-2307
NPI assigned
Nov 29, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2017

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

Authorized official

Name
Mackenzie Hahn
Title
Ncpdp Coordinator
Phone
(479) 636-9702

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X MD.020506 LA Primary

Addresses

Primary practice location

7015 Hwy 190 E Service Rd.
Ste 101
Covington, LA 70433

Mailing address

PO Box 3328
Bentonville, AR 72712
Phone (479) 636-9702

Other names 1

  • Premier Pain Center Doing business as

National Provider Directory

National Provider Directory

Locations

7015 Highway 190 East Service Rd
Ste 101
Covington, LA 70433
Phone (985) 809-1997

NPI Registry JSON

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511913600000",
    "number": "1144734153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3328",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "72712",
            "telephone_number": "479-636-9702",
            "fax_number": "877-427-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7015 HWY 190 E SERVICE RD.",
            "address_2": "STE 101",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "70433",
            "telephone_number": "479-636-9702",
            "fax_number": "877-427-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE INTERVENTIONAL PAIN MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-29",
        "last_updated": "2017-11-29",
        "status": "A",
        "authorized_official_last_name": "HAHN",
        "authorized_official_first_name": "MACKENZIE",
        "authorized_official_title_or_position": "NCPDP COORDINATOR",
        "authorized_official_telephone_number": "479-636-9702"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "LA",
            "license": "MD.020506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Pain Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2017; 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.