Pain Treatment Center Inc

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

109904 Issued in MO

Legal business name

PAIN TREATMENT CENTER INC

Practice address

2821 N Ballas Rd
Suite C-11
Saint Louis, MO 63131-2321

Phone

(314) 872-5601

Fax

(314) 872-5628

NPI assigned

Sep 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John David Graham, MD

Title

Owner President

Phone

(314) 872-5601

Specialties & licenses 2

Addresses

Other identifiers 10

Locations

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270425600000",
    "number": "1295827665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 953010",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631953010",
            "telephone_number": "314-872-5601",
            "fax_number": "314-872-5628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 N BALLAS RD",
            "address_2": "SUITE C-11",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312321",
            "telephone_number": "314-872-5601",
            "fax_number": "314-872-5628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN TREATMENT CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2010-04-05",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "314-872-5601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MO",
            "license": "109904",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036092540",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "115491",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "050065227",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEATHCARE",
            "identifier": "2000288",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMR",
            "identifier": "28931",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004669135",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "114762",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP ASO LHI",
            "identifier": "28931",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "30087",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "322628",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE NORTH WEST",
            "identifier": "514766005",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pain and Performance Relief LLC
• Pain Care Innovations
• Pain Management Partners LLC
• Pain Rehab Products, Inc.
• Pain Relief Center of St Louis LLC
• Marilyn Jeanne Kastner Painter, MS CCC SLP
• Pairidex Inc.
• Julia Pakey, MD
• Aratrika Pal, MD
• Priya Pal, MD

• Pain Medicine (Anesthesiology) Physician in Saint Louis, MO
• Providers in Saint Louis, 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 Apr 5, 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.