Innovative Pain and Spine Physicians

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

Legal business name

INNOVATIVE PAIN AND SPINE PHYSICIANS

Practice address

4418 Vineland Ave Ste 218
North Hollywood, CA 91602-2159

Phone

(818) 621-0019

NPI assigned

Nov 15, 2014

Organization subpart

No

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

Authorized official

Name

Matthew S Root, D.O.

Title

Authorized Official

Phone

(818) 621-0019

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

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

{
    "created_epoch": "1416009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569715200000",
    "number": "1174929376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4418 VINELAND AVE STE 218",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916022159",
            "telephone_number": "818-621-0019",
            "fax_number": "818-671-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4418 VINELAND AVE STE 218",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916022159",
            "telephone_number": "818-621-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE PAIN AND SPINE PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-15",
        "last_updated": "2019-09-29",
        "status": "A",
        "authorized_official_last_name": "ROOT",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "818-621-0019",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1043593098",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "CB228966",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "message@innovativepainspine.com",
            "affiliation": "N",
            "address_1": "4418 Vineland Ave Ste 218",
            "city": "North Hollywood",
            "state": "CA",
            "country_code": "US",
            "postal_code": "916022159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pain Medicine (Physical Medicine & Rehabilitation) Physician in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2019; 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.