Comprehensive Pain Rehab of Southern Indiana LLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

COMPREHENSIVE PAIN REHAB OF SOUTHERN INDIANA LLC

Doing business as

Pain Management Surgery Center

Practice address

2920 McIntire Drive
Suite 150a
Bloomington, IN 47403-4213

Phone

(812) 376-7246

Fax

(812) 314-5001

NPI assigned

Aug 25, 2010

Last updated

Aug 25, 2010By 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

Derk Frasier

Title

Owner

Phone

(812) 376-7246

Specialties & licenses 4

Addresses

Other names 1

• Pain Management Surgery Center Doing business as

Tax ID family

Comprehensive Pain Rehab of Southern Indiana LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Comprehensive Pain Rehab of Southern Indiana LLC

  dba Pain Management Surgery Center

  • Pain Medicine Physician
  • Bloomington, IN
  • NPI 1578870879
  NPD tax ID
• Comprehensive Pain Rehab of Southern Indiana LLC

  dba Pain Management Surgery Center

  • Pain Medicine Physician
  • Indianapolis, IN
  • NPI 1689981979
  NPD tax ID

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282694400000",
    "number": "1245546506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 MCINTIRE DRIVE",
            "address_2": "SUITE 150A",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034213",
            "telephone_number": "812-376-7246",
            "fax_number": "812-314-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 MCINTIRE DRIVE",
            "address_2": "SUITE 150A",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034213",
            "telephone_number": "812-376-7246",
            "fax_number": "812-314-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE PAIN REHAB OF SOUTHERN INDIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-25",
        "last_updated": "2010-08-25",
        "status": "A",
        "authorized_official_last_name": "FRASIER",
        "authorized_official_first_name": "DERK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-376-7246"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain Management Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Comprehensive Pain Rehab of Southern Indiana LLC (Pain Management Surgery Center)
• Comprehensive Spine Care
• Michelle Heck Compton-Craig, PT
• Amari Compton, RBT
• Miranda Conard, PHARMD

• Pain Medicine Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Pain Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; 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.