Organization Active NPI

Integrative Pain Management, LLC

  • Chiropractor
  • Tempe, AZ
National Provider Identifier
1194989715
Registry record updated Mar 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5311 Issued in AZ
Legal business name
INTEGRATIVE PAIN MANAGEMENT, LLC
Practice address
1858 E Southern Ave
Tempe, AZ 85282-5836
Phone
(480) 858-1868
Fax
(480) 838-8887
NPI assigned
Jul 13, 2008
Last updated
Mar 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2016

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

Authorized official

Name
Dr. Gregory Katsaros, D.C.NPI 1235136946
Title
Owner/Physician
Phone
(480) 858-1868

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
Chiropractor 111N00000X 5311 AZ Primary

Addresses

Primary practice location

1858 E Southern Ave
Tempe, AZ 85282-5836

Mailing address

1858 E Southern Ave
Tempe, AZ 85282-5836
Phone (480) 858-1868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040614000819 AZ Part B Supplier - Clinic/Group Practice 4789668260 Receives reassigned benefits from 1 practitioner
Practice locations: Tempe, AZ

National Provider Directory

National Provider Directory

Locations

1050 E Southern Ave
Ste 5
Tempe, AZ 85282
Phone (480) 858-1868

1050 E Southern Ave
Ste 7
Tempe, AZ 85282
Phone (480) 858-1868

1208 E Broadway Rd
Ste 100
Tempe, AZ 85282
Phone (480) 858-1868

1858 E Southern Ave
Tempe, AZ 85282
Phone (480) 755-1925

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1215907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457654400000",
    "number": "1194989715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1858 E SOUTHERN AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852825836",
            "telephone_number": "480-858-1868",
            "fax_number": "480-838-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1858 E SOUTHERN AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852825836",
            "telephone_number": "480-858-1868",
            "fax_number": "480-838-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE PAIN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-13",
        "last_updated": "2016-03-11",
        "status": "A",
        "authorized_official_last_name": "KATSAROS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "480-858-1868",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.