Innovative Pain Medicine Center of Colorado - a Professional Company

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

40692 Issued in CO

Legal business name

INNOVATIVE PAIN MEDICINE CENTER OF COLORADO - A PROFESSIONAL COMPANY

Practice address

4348 Woodlands Blvd
Suite 230
Castle Rock, CO 80104-2800

Phone

(303) 663-2797

Fax

(303) 663-2953

NPI assigned

Nov 1, 2010

Last updated

Aug 17, 2011By 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

Patricia L Little, MD

Title

President

Phone

(303) 663-2797

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313539200000",
    "number": "1255631776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801040778",
            "telephone_number": "303-663-2797",
            "fax_number": "303-663-2953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4348 WOODLANDS BLVD",
            "address_2": "SUITE 230",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801042800",
            "telephone_number": "303-663-2797",
            "fax_number": "303-663-2953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE PAIN MEDICINE CENTER OF COLORADO - A PROFESSIONAL COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-01",
        "last_updated": "2011-08-17",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-663-2797",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CO",
            "license": "40692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2011; 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.