Organization Active NPI

Comprehensive Pain Medicine Center

  • Specialist
  • Covington, LA
National Provider Identifier
1417141995
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
556 Issued in LA
Legal business name
COMPREHENSIVE PAIN MEDICINE CENTER
Practice address
67230 Industry LN
Ste 2
Covington, LA 70433-8704
Phone
(985) 801-6285
Fax
(985) 801-6269
NPI assigned
Aug 28, 2007
Last updated
Aug 28, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
FAIRWAY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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

Authorized official

Name
Mr. David Guzan
Title
Ceo
Phone
(985) 809-9888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 556 LA Primary

Addresses

Primary practice location

67230 Industry LN
Ste 2
Covington, LA 70433-8704

Mailing address

67230 Industry LN
Ste 2
Covington, LA 70433-8704
Phone (985) 801-6285

National Provider Directory

National Provider Directory
Part of
Fairway Medical Center LLC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

67230 Industry Ln
Ste 2
Covington, LA 70433
Phone (985) 801-6285

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188259200000",
    "number": "1417141995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67230 INDUSTRY LN",
            "address_2": "STE 2",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338704",
            "telephone_number": "985-801-6285",
            "fax_number": "985-801-6269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67230 INDUSTRY LN",
            "address_2": "STE 2",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338704",
            "telephone_number": "985-801-6285",
            "fax_number": "985-801-6269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE PAIN MEDICINE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAIRWAY MEDICAL CENTER",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A",
        "authorized_official_last_name": "GUZAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "985-809-9888",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "LA",
            "license": "556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; 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.