Michiana Spine, Sports & Occupational Rehab, PC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

4301070312 Issued in MI

Legal business name

MICHIANA SPINE, SPORTS & OCCUPATIONAL REHAB, PC

Practice address

2500 Niles Rd Ste 3
Saint Joseph, MI 49085-3225

Phone

(574) 252-4150

Fax

(574) 252-4159

NPI assigned

May 7, 2012

Organization subpart

No

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

Authorized official

Name

Kevin G Drew, MDNPI 1275538373

Title

Owner

Phone

(574) 252-4150

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin Gene Drew, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Mishawaka, IN
  • NPI 1275538373
  NPD (past) Authorized official

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

{
    "created_epoch": "1336348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667433600000",
    "number": "1407115884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 EDISON LAKES PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453474",
            "telephone_number": "574-252-4150",
            "fax_number": "574-252-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NILES RD STE 3",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853225",
            "telephone_number": "574-252-4150",
            "fax_number": "574-252-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIANA SPINE, SPORTS & OCCUPATIONAL REHAB, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-07",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "DREW",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-252-4150",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MI",
            "license": "4301070312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Rose Meyers
• Michael R & Sharie S Conard (Studio I)
• Michiana Regional Sleep Disorders Center P.C.
• Michiana Regional Sleep Disorders Center P.C.
• Michiana Sleep & Pulmonary Associates P.C.
• Midwest Neurobehavioral Center PC
• Scott A Mihalik, P.A.-C.
• David Scott Miller, DDS
• Laura Miller
• Lauren Virginia Chatfield Miller, D.O.

• Interventional Pain Medicine Physician in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Interventional Pain Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.