NPIMap

Organization Active NPI

Integrative Spine and Pain Management, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Brighton, MI
National Provider Identifier
1184863748
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
INTEGRATIVE SPINE AND PAIN MANAGEMENT, PLLC
Practice address
12851 Grand River Rd
Brighton, MI 48116-8506
Phone
(810) 606-7181
Fax
(810) 606-7174
NPI assigned
Feb 5, 2009
Last updated
Feb 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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

Authorized official

Name
Dr. Richard Jay Kovan, M.D.NPI 1891751509
Title
Physician
Phone
(810) 606-7181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

12851 Grand River Rd
Brighton, MI 48116-8506

Mailing address

4632 Genesys Pkwy
Grand Blanc, MI 48439-8067
Phone (810) 606-7181

National Provider Directory

National Provider Directory

Locations

12851 Grand River Rd
Brighton, MI 48116
Phone (810) 225-2506

4632 Genesys Pkwy
Grand Blanc, MI 48439
Phone (810) 606-7181

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233792000000",
    "number": "1184863748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4632 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398067",
            "telephone_number": "810-606-7181",
            "fax_number": "810-606-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12851 GRAND RIVER RD",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481168506",
            "telephone_number": "810-606-7181",
            "fax_number": "810-606-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE SPINE AND PAIN MANAGEMENT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-05",
        "last_updated": "2009-02-05",
        "status": "A",
        "authorized_official_last_name": "KOVAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "810-606-7181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.