NPIMap

Organization Active NPI

Interventional Pain Institute, LLC

  • Specialist
  • Festus, MO
National Provider Identifier
1336461771
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
INTERVENTIONAL PAIN INSTITUTE, LLC
Practice address
1405 N Truman Blvd
Festus, MO 63028-1177
Phone
(636) 933-2243
Fax
(636) 933-2252
NPI assigned
Feb 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Authorized official

Name
Ramis Gheith, MDNPI 1063611895
Title
Physician/Owner
Phone
(636) 933-2243

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X MO

Addresses

Primary practice location

1405 N Truman Blvd
Festus, MO 63028-1177

Mailing address

1405 N Truman Blvd
Festus, MO 63028-1177
Phone (636) 933-2243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20100605000061 MO Part B Supplier - Clinic/Group Practice 1153451919 Receives reassigned benefits from 12 practitioners
Practice locations: Bridgeton, MO; Chesterfield, MO; Festus, MO; Saint Charles, MO; Saint Robert, MO; Troy, MO
O20140207000469 MO DME Supplier - Physician - Anesthesiology 1153451919 Practice locations: Festus, MO
O20240122000604 IL Part B Supplier - Clinic/Group Practice 1153451919 Receives reassigned benefits from 14 practitioners
Practice locations: O Fallon, IL; Swansea, IL; Edwardsville, IL; Alton, IL

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Interventional Pain LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12 Wolf Creek Dr
Ste 201
Swansea, IL 62226

12255 De Paul Dr
Ste 830
Bridgeton, MO 63044
Phone (314) 291-6556

Practitioners & affiliated clinicians

Practitioners 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1267142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1336461771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 N TRUMAN BLVD",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630281177",
            "telephone_number": "636-933-2243",
            "fax_number": "636-933-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 N TRUMAN BLVD",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630281177",
            "telephone_number": "636-933-2243",
            "fax_number": "636-933-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL PAIN INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-26",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "GHEITH",
        "authorized_official_first_name": "RAMIS",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "636-933-2243",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.