NPIMap

Organization Active NPI

Professional Physicians Pain Services, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Saint Peters, MO
National Provider Identifier
1295062016
Registry record updated Nov 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
PROFESSIONAL PHYSICIANS PAIN SERVICES, LLC
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2009

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.
Title
Partner of the LLC
Phone
(636) 442-5035

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X MO Primary

Addresses

Primary practice location

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

Mailing address

PO Box 31434
Saint Louis, MO 63131-0434
Phone (636) 442-5035

Other names 1

  • Professional Pain Physicians Doing business as

National Provider Directory

National Provider Directory

Locations

114 Piper Hill Dr
Ste 103
Saint Peters, MO 63376
Phone (314) 308-5009

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 1

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": "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"
        }
    ]
}

Other providers in Saint Peters, MO

Sources for this page

  • 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.