Organization Active NPI

Headache & Pain Center, a Medical Corporation

  • Durable Medical Equipment & Medical Supplies
  • New Iberia, LA
National Provider Identifier
1326546276
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
HEADACHE & PAIN CENTER, A MEDICAL CORPORATION
Practice address
531A Jefferson Ter
New Iberia, LA 70560-4949
Phone
(337) 560-0880
Fax
(337) 560-0870
NPI assigned
Jan 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2018

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

Authorized official

Name
Dr. Jimmy Nolan Ponder Jr., MDNPI 1689644874
Title
Ceo
Phone
(985) 580-1200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

531A Jefferson Ter
New Iberia, LA 70560-4949

Mailing address

123 Frontage Road a
Gray, LA 70359-6301
Phone (985) 580-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180201002957 LA DME Supplier - Physician - Interventional Pain Management 5890777114 Practice locations: New Iberia, LA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

149 Frontage Road a
Gray, LA 70359
Phone (985) 580-1200

Practitioners & affiliated clinicians

Practitioners 9

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": "1516838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516838400000",
    "number": "1326546276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 FRONTAGE ROAD A",
            "city": "GRAY",
            "state": "LA",
            "postal_code": "703596301",
            "telephone_number": "985-580-1200",
            "fax_number": "985-580-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531A JEFFERSON TER",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705604949",
            "telephone_number": "337-560-0880",
            "fax_number": "337-560-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEADACHE & PAIN CENTER, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-25",
        "last_updated": "2018-01-25",
        "status": "A",
        "authorized_official_last_name": "PONDER",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "NOLAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "985-580-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Iberia, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; 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.