NPIMap

Organization Active NPI

Premier Interventional Pain of Ohio LLC

  • Interventional Pain Medicine Physician
  • Columbus, OH
National Provider Identifier
1265855795
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
PREMIER INTERVENTIONAL PAIN OF OHIO LLC
Practice address
793 W State St
Columbus, OH 43222-1551
Phone
(770) 643-5501
Fax
(404) 941-1304
NPI assigned
Feb 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

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

Authorized official

Name
Kerry Teel
Title
President
Phone
(770) 643-5501

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193200000X MULTI-SPECIALTY GROUP 204E00000X
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X
Anesthesiologist AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 367H00000X

Addresses

Primary practice location

793 W State St
Columbus, OH 43222-1551

Mailing address

2655 Northwinds Pkwy
Alpharetta, GA 30009-2280
Phone (770) 643-5501

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1391472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391558400000",
    "number": "1265855795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 NORTHWINDS PKWY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300092280",
            "telephone_number": "770-643-5501",
            "fax_number": "404-941-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "793 W STATE ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221551",
            "telephone_number": "770-643-5501",
            "fax_number": "404-941-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER INTERVENTIONAL PAIN OF OHIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-04",
        "last_updated": "2014-02-05",
        "status": "A",
        "authorized_official_last_name": "TEEL",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-643-5501"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; 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.