NPIMap

Organization Active NPI

Interventions in Pain Management LLC

  • Pain Clinic/Center
  • Rock Island, IL
National Provider Identifier
1417370537
Registry record updated May 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
INTERVENTIONS IN PAIN MANAGEMENT LLC
Practice address
4110 Blackhawk Rd
Rock Island, IL 61201-7039
Phone
(309) 428-7055
NPI assigned
Jan 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2016

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

Authorized official

Name
Kerry Panozzo, MDNPI 1225017957
Title
Owner
Phone
(309) 428-7055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 036090677 IL
Pain Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

4110 Blackhawk Rd
Rock Island, IL 61201-7039

Mailing address

PO Box 689
Lake Forest, IL 60045-0689
Phone (847) 615-2200

National Provider Directory

National Provider Directory
Tax ID family
Kerry Panozzo MD PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462492800000",
    "number": "1417370537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600450689",
            "telephone_number": "847-615-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 BLACKHAWK RD",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017039",
            "telephone_number": "309-428-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONS IN PAIN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-24",
        "last_updated": "2016-05-06",
        "status": "A",
        "authorized_official_last_name": "PANOZZO",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-428-7055",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036090677",
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; 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.