Anodyne of Manchester, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

ANODYNE OF MANCHESTER, LLC

Doing business as

Anodyne Pain and Wellness Solutions

Practice address

1001 Brittany Pkwy
Manchester, MO 63011-4325

Phone

(636) 330-7246

NPI assigned

Dec 6, 2020

Last updated

Apr 18, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jonathan Pollock

Title

Manager

Phone

(636) 330-7246

Specialties & licenses 3

Addresses

Other names 1

• Anodyne Pain and Wellness Solutions Doing business as

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

{
    "created_epoch": "1607212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1376149393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BRITTANY PKWY",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630114325",
            "telephone_number": "636-330-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BRITTANY PKWY",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630114325",
            "telephone_number": "636-330-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANODYNE OF MANCHESTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-06",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "POLLOCK",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "636-330-7246"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anodyne Pain and Wellness Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Anodyne Pain and Wellness Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Medicine & Rehabilitation Physician in Manchester, MO
• Providers in Manchester, MO by specialty
• Physical Medicine & Rehabilitation Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.