Brentwood Painstop LLC

Primary specialty

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

License

2014010441 Issued in MO

Legal business name

BRENTWOOD PAINSTOP LLC

Practice address

8045 Big Bend Blvd Ste 107
Saint Louis, MO 63119-2714

Phone

(314) 961-7181

NPI assigned

Oct 4, 2017

Last updated

Oct 4, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicholas J Divan, DCNPI 1114343704

Title

Chiropractor

Phone

(314) 961-7181

Specialties & licenses 2

Addresses

Practitioners 1

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.

• Nicholas Divan, D.C.

  • Rehabilitation Chiropractor
  • Saint Louis, MO
  • NPI 1114343704
  Authorized official Same address or phone

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507075200000",
    "number": "1225548290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8045 BIG BEND BLVD STE 107",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631192714",
            "telephone_number": "314-961-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8045 BIG BEND BLVD STE 107",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631192714",
            "telephone_number": "314-961-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENTWOOD PAINSTOP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-10-04",
        "status": "A",
        "authorized_official_last_name": "DIVAN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "314-961-7181",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "MO",
            "license": "2014010441",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MO",
            "license": "2014010441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Brentlinger
• Brentmoor Delmar - Spvef, LLC (Brentmoor Retirement Community)
• Brentmoor Retirement Community
• Brentwood Family Chiropractic Center, LLC
• Brentwood Family Dental Center, LLC
• Brentwood Pediatrics PC
• Brentwood Physical Therapy Limited (Brentwood Center Of Health)
• Alexander Angelo Brescia, MD
• Carol Zarinelli Brescia, L.C.S.W.
• Madeleine Rose Bresnahan

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.