Professional Physicians Pain Services, LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

PROFESSIONAL PHYSICIANS PAIN SERVICES, LLC

Doing business as

Professional Pain Physicians

Practice address

114 Piper Hill Dr
Suite 103
Saint Peters, MO 63376-1661

Phone

(636) 442-5035

Fax

(636) 442-5036

NPI assigned

Nov 16, 2009

Last updated

Nov 16, 2009By 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

Mr. Michael S. Boedefeld, M. D.NPI 1043299548

Title

Partner of the LLC

Phone

(636) 442-5035

Specialties & licenses 1

Addresses

Other names 1

• Professional Pain Physicians Doing business as

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DBHJAA

Practitioners 2

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.

• Michael Scott Boedefeld, MD

  • Pain Medicine (Anesthesiology) Physician
  • Fenton, MO
  • NPI 1043299548
  Authorized official Same address or phone
• Chad Conrad Shelton, MD

  • Pain Medicine (Anesthesiology) Physician
  • Saint Peters, MO
  • NPI 1194758938
  NPD (past)

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

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258329600000",
    "number": "1295062016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31434",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631310434",
            "telephone_number": "636-442-5035",
            "fax_number": "636-442-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 PIPER HILL DR",
            "address_2": "SUITE 103",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761661",
            "telephone_number": "636-442-5035",
            "fax_number": "636-442-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PHYSICIANS PAIN SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-16",
        "last_updated": "2009-11-16",
        "status": "A",
        "authorized_official_last_name": "BOEDEFELD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PARTNER OF THE LLC",
        "authorized_official_telephone_number": "636-442-5035",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Pain Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pain Medicine (Anesthesiology) Physician in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Pain Medicine (Anesthesiology) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; 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.