NPIMap

Organization Active NPI

MD Pain LLC

  • Pain Medicine (Anesthesiology) Physician
  • Lincoln, NE
National Provider Identifier
1235668294
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
MD PAIN LLC
Practice address
4130 Pioneer Woods Dr Ste 4
Lincoln, NE 68506-7552
Phone
(402) 858-0117
Fax
(402) 477-9295
NPI assigned
Jun 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Authorized official

Name
John R Massey, MDNPI 1922063528
Title
Owner
Phone
(402) 858-0117

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X Primary
Clinic/Center 261Q00000X

Addresses

Primary practice location

4130 Pioneer Woods Dr Ste 4
Lincoln, NE 68506-7552

Mailing address

4130 Pioneer Woods Dr Ste 4
Lincoln, NE 68506-7552
Phone (402) 858-0117

Other practice location 1

450 E 23rd St
Fremont, NE 68025-9802
Phone (402) 721-1610

Other practice location 2

2222 N Lincoln Ave
York, NE 68467-1030
Phone (402) 362-6671

Other practice location 3

1760 County Road J
Wahoo, NE 68066-4152
Phone (402) 443-1455

Other practice location 4

4508 38th St Ste 210
Columbus, NE 68601-1668
Phone (402) 562-4802

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170901003000 NE Part B Supplier - Clinic/Group Practice 3274806807 Receives reassigned benefits from 6 practitioners
Practice locations: Fremont, NE; Friend, NE; Lincoln, NE; Wahoo, NE; York, NE; Columbus, NE

National Provider Directory

National Provider Directory

Locations

4508 38th St
Ste 2010
Columbus, NE 68601

4130 Pioneer Woods Dr
Ste 4
Lincoln, NE 68506
Phone (402) 858-0117

7555 Pioneers Blvd
Lincoln, NE 68506
Phone (402) 261-1085

8540 Executive Woods Dr
Ste 500
Lincoln, NE 68512
Phone (402) 986-6494

4130 Pioneer Woods Dr
Lincoln, NE 68506
Phone (402) 261-6841

Practitioners & affiliated clinicians

Practitioners 7

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": "1496620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686268800000",
    "number": "1235668294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 PIONEER WOODS DR STE 4",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685067552",
            "telephone_number": "402-858-0117",
            "fax_number": "402-477-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 PIONEER WOODS DR STE 4",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685067552",
            "telephone_number": "402-858-0117",
            "fax_number": "402-477-9295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 E 23rd St",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "NE",
            "postal_code": "680259802",
            "country_code": "US",
            "telephone_number": "402-721-1610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 N Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "NE",
            "postal_code": "684671030",
            "country_code": "US",
            "telephone_number": "402-362-6671",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1760 County Road J",
            "address_purpose": "LOCATION",
            "city": "Wahoo",
            "state": "NE",
            "postal_code": "680664152",
            "country_code": "US",
            "telephone_number": "402-443-1455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4508 38th St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "NE",
            "postal_code": "686011668",
            "country_code": "US",
            "telephone_number": "402-562-4802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MD PAIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-05",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A",
        "authorized_official_last_name": "MASSEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-858-0117",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.