NPIMap

Organization Active NPI

Omni Spine Pain Management, PLLC

  • Interventional Pain Medicine Physician
  • Desoto, TX
National Provider Identifier
1184227746
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
OMNI SPINE PAIN MANAGEMENT, PLLC
Practice address
947 Scotland Dr Ste 107
Desoto, TX 75115-2095
Phone
(214) 705-1200
Fax
(214) 705-1201
NPI assigned
Nov 17, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Authorized official

Name
Whitney Rae Hughes
Title
Billing Department
Phone
(972) 645-1260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

947 Scotland Dr Ste 107
Desoto, TX 75115-2095

Mailing address

8380 Warren Pkwy Ste 100
Frisco, TX 75034-4199
Phone (214) 705-1200

Other identifiers 1

IdentifierTypeStateIssuer
N1784OtherTXSTATE LICENSE NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Omni Spine Pain MGMT PLLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

947 Scotland Dr
Ste 107
Desoto, TX 75115
Phone (214) 705-1200

4760 Preston Rd
#244261
Frisco, TX 75034

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638748800000",
    "number": "1184227746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8380 WARREN PKWY STE 100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344199",
            "telephone_number": "214-705-1200",
            "fax_number": "214-705-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 SCOTLAND DR STE 107",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152095",
            "telephone_number": "214-705-1200",
            "fax_number": "214-705-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI SPINE PAIN MANAGEMENT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-17",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "BILLING DEPARTMENT",
        "authorized_official_telephone_number": "972-645-1260"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "N1784",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.