Interventions in Pain Management LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

INTERVENTIONS IN PAIN MANAGEMENT LLC

Practice address

1075 Golden Valley Dr
Bettendorf, IA 52722-1649

Phone

(309) 428-7055

NPI assigned

May 29, 2015

Organization subpart

No

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

Authorized official

Name

Kerry P Panozzo

Title

Owner

Phone

(309) 721-3288

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1432857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479427200000",
    "number": "1174902605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 BLACKHAWK RD STE 2",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017039",
            "telephone_number": "309-428-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 GOLDEN VALLEY DR",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221649",
            "telephone_number": "309-428-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONS IN PAIN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-29",
        "last_updated": "2016-11-18",
        "status": "A",
        "authorized_official_last_name": "PANOZZO",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-721-3288"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IA",
            "license": "34922",
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Bettendorf, IA
• Pain Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.