Premier Pain Management, LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

OTC4333 Issued in AZ

Legal business name

PREMIER PAIN MANAGEMENT, LLC

Practice address

4540 E Baseline Rd Ste 112
Mesa, AZ 85206-4616

Phone

(480) 272-8944

Fax

(480) 237-5682

NPI assigned

Jan 24, 2008

Organization subpart

No

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

Authorized official

Name

Dr. James Sieffert, DC

Title

Clinical Administrator

Phone

(280) 272-8944

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1174700975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 E BASELINE RD STE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064616",
            "telephone_number": "480-272-8944",
            "fax_number": "480-237-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 E BASELINE RD STE 112",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064616",
            "telephone_number": "480-272-8944",
            "fax_number": "480-237-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PAIN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-24",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "SIEFFERT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CLINICAL ADMINISTRATOR",
        "authorized_official_telephone_number": "280-272-8944",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "AZ",
            "license": "OTC4333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTC LICENSCE",
            "identifier": "OTC4913",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kamala Premkumar, MD

• Pain Clinic/Center in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Pain Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; 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.