NPIMap

Organization Active NPI

Professional Pain Managment Associates

  • Pain Medicine (Anesthesiology) Physician
  • Williamstown, NJ
National Provider Identifier
1154592103
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
25MB04459800 Issued in NJ
Legal business name
PROFESSIONAL PAIN MANAGMENT ASSOCIATES
Practice address
2007 N Black Horse Pike
Williamstown, NJ 08094-9120
Phone
(856) 740-4888
Fax
(856) 740-0559
NPI assigned
Mar 18, 2008
Last updated
Mar 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Authorized official

Name
Carol Lingo
Title
Business Office Manager
Phone
(856) 740-6213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X 25MB04459800 NJ Primary

Addresses

Primary practice location

2007 N Black Horse Pike
Williamstown, NJ 08094-9120

Mailing address

PO Box 8890
Turnersville, NJ 08012-8890
Phone (856) 740-4888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110617000504 NJ Part B Supplier - Clinic/Group Practice 3577741743 Receives reassigned benefits from 10 practitioners
Practice locations: Cherry Hill, NJ; Williamstown, NJ; Vineland, NJ; Somers Point, NJ; Princeton, NJ; Northfield, NJ

National Provider Directory

National Provider Directory

Locations

802 Tilton Rd
Northfield, NJ 08225
Phone (609) 569-1900

510 E Landis Ave
Vineland, NJ 08360
Phone (856) 691-0361

Practitioners & affiliated clinicians

Practitioners 11

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": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1154592103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8890",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080128890",
            "telephone_number": "856-740-4888",
            "fax_number": "856-740-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 N BLACK HORSE PIKE",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080949120",
            "telephone_number": "856-740-4888",
            "fax_number": "856-740-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PAIN MANAGMENT ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "LINGO",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "856-740-6213"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "25MB04459800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamstown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.