Better Life Pain Clinic, PLLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

0101250991 Issued in VA

Legal business name

BETTER LIFE PAIN CLINIC, PLLC

Practice address

11166 Fairfax Blvd
Suite 105
Fairfax, VA 22030-5017

Phone

(703) 277-3360

Fax

(703) 277-3370

NPI assigned

Jun 21, 2012

Organization subpart

No

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

Authorized official

Name

Su Min Ko, MDNPI 1336375450

Title

Owner

Phone

(347) 325-4390

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Better Life Pain Clinic, PLLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Annandale, VA
  • NPI 1659792323

  O20121203000013

  Same enrollment

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Su Min Ko, M.D.

  • Interventional Pain Medicine Physician
  • Fairfax, VA
  • NPI 1336375450
  NPD Authorized official

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1306109590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11166 FAIRFAX BLVD",
            "address_2": "SUITE 105",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305017",
            "telephone_number": "703-277-3360",
            "fax_number": "703-277-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11166 FAIRFAX BLVD",
            "address_2": "SUITE 105",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305017",
            "telephone_number": "703-277-3360",
            "fax_number": "703-277-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETTER LIFE PAIN CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-21",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "KO",
        "authorized_official_first_name": "SU MIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-325-4390",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "VA",
            "license": "0101250991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Bethay
• Maureen Smith Bethea, LMFT
• Better Days Home Healthcare Professionals LLC
• Better Health Clinic, Inc
• Better Life Inc.
• Sophia Bettger
• Shelby Rae Bettoney, PA-C
• Erica Bettwy, LCSW
• Caitlin Betz
• Roy A Beveridge, M.D.

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.