NPIMap

Organization Active NPI

Pain Management Centers of America, PSC

  • Interventional Pain Medicine Physician
  • Paducah, KY
National Provider Identifier
1407323918
Registry record updated Apr 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
PAIN MANAGEMENT CENTERS OF AMERICA, PSC
Practice address
67 Lakeview Dr
Paducah, KY 42001-5619
Phone
(812) 477-7246
Fax
(812) 477-7240
NPI assigned
Nov 1, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2022

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

Authorized official

Name
Mahendra R. Sanapati, MD
Title
President
Phone
(812) 477-7246

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X Primary
Durable Medical Equipment & Medical Supplies 332B00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

67 Lakeview Dr
Paducah, KY 42001-5619

Mailing address

1101 Professional Blvd Ste 100
Evansville, IN 47714-8018
Phone (812) 477-7246

Other identifiers 1

IdentifierTypeStateIssuer
710053770MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.pmcoa.us

National Provider Directory

National Provider Directory
Tax ID family
Pain Management Centers of America PSC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651276800000",
    "number": "1407323918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 PROFESSIONAL BLVD STE 100",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148018",
            "telephone_number": "812-477-7246",
            "fax_number": "812-477-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 LAKEVIEW DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420015619",
            "telephone_number": "812-477-7246",
            "fax_number": "812-477-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MANAGEMENT CENTERS OF AMERICA, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-01",
        "last_updated": "2022-04-30",
        "certification_date": "2022-04-30",
        "status": "A",
        "authorized_official_last_name": "SANAPATI",
        "authorized_official_first_name": "MAHENDRA",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-477-7246",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "710053770",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.pmcoa.us",
            "affiliation": "N",
            "address_1": "67 Lakeview Dr",
            "city": "Paducah",
            "state": "KY",
            "country_code": "US",
            "postal_code": "420015619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.