Midwest Spine Interventionalist,LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

35-087792 Issued in OH

Legal business name

MIDWEST SPINE INTERVENTIONALIST,LLC

Doing business as

Interventional Spine & Pain Center

Practice address

578 N Main St
Springboro, OH 45066-9552

Phone

(937) 619-0724

Fax

(937) 619-0400

NPI assigned

Mar 28, 2007

Last updated

Oct 1, 2021By 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

Dr. Vivekanand Manocha, MD

Title

Owner

Phone

(937) 619-0724

Specialties & licenses 1

Addresses

Other names 1

• INTERVENTIONAL SPINE & PAIN CENTER Doing business as

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1752/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1407975493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 N MAIN ST",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450669552",
            "telephone_number": "937-619-0724",
            "fax_number": "937-619-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "578 N MAIN ST",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450669552",
            "telephone_number": "937-619-0724",
            "fax_number": "937-619-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST SPINE INTERVENTIONALIST,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "MANOCHA",
        "authorized_official_first_name": "VIVEKANAND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-619-0724",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "OH",
            "license": "35-087792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INTERVENTIONAL SPINE & PAIN CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "INTERVENTIONAL SPINE & PAIN CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lacey Aileen McKenzie, CNP
• Katie McMenamin, NP
• Middletown Eyecare Inc (Settlers Walk EyeCare)
• Midwest Apn Consultants LLC (Tracy Murray)
• Midwest Behavioral Care
• Cynthia B Miller, RN LMT
• Joshua Miller, LPC
• Mary Soisson Miller, MSW, LISW
• Rebecca Miller, PT
• Traci Mills, M.S., CCC-SLP

• Interventional Pain Medicine Physician in Springboro, OH
• Providers in Springboro, OH by specialty
• Interventional Pain Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.