Organization Active NPI

Pain Management and Wellness Institute, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Phoenix, AZ
National Provider Identifier
1346694676
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
PAIN MANAGEMENT AND WELLNESS INSTITUTE, PLLC
Practice address
10810 N Tatum Blvd
Suite 102-302
Phoenix, AZ 85028-6055
Phone
(602) 740-1333
NPI assigned
Apr 23, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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

Authorized official

Name
Dallin Jenkins
Title
Manager
Phone
(480) 265-0890

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X Primary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X

Addresses

Primary practice location

10810 N Tatum Blvd
Suite 102-302
Phoenix, AZ 85028-6055

Mailing address

10810 N Tatum Blvd
Suite 102-302
Phoenix, AZ 85028-6055

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1461369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543968000000",
    "number": "1346694676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10810 N TATUM BLVD",
            "address_2": "SUITE 102-302",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10810 N TATUM BLVD",
            "address_2": "SUITE 102-302",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286055",
            "telephone_number": "602-740-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MANAGEMENT AND WELLNESS INSTITUTE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-23",
        "last_updated": "2018-12-05",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "DALLIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-265-0890"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; 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.