Iowa Illinois Pain Consultants P.C.

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

26118 Issued in IA

Legal business name

IOWA ILLINOIS PAIN CONSULTANTS P.C.

Practice address

3385 Dexter CT
Ste 300
Davenport, IA 52807-3494

Phone

(563) 424-0512

Fax

(563) 326-6236

NPI assigned

Apr 29, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Jon Miller, MDNPI 1265439947

Title

President

Phone

(563) 424-0512

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9731/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Timothy J. Miller, M.D.

  • Pain Medicine Physician
  • Davenport, IA
  • NPI 1265439947
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425254400000",
    "number": "1336314574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 580",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527220010",
            "telephone_number": "563-424-0512",
            "fax_number": "563-326-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3385 DEXTER CT",
            "address_2": "STE 300",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073494",
            "telephone_number": "563-424-0512",
            "fax_number": "563-326-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA ILLINOIS PAIN CONSULTANTS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2015-03-02",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-424-0512",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "IA",
            "license": "26118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4024711",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "14316",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036079595",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Iowa Plastic Surgery Center LC
• Iowa Plastic Surgery, PC
• Ashlynn Ireland

• Pain Clinic/Center in Davenport, IA
• Providers in Davenport, IA by specialty
• Pain Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; 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.