NPIMap

Organization Active NPI

Advanced Spine and Pain PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Draper, UT
National Provider Identifier
1437627080
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
ADVANCED SPINE AND PAIN PLLC
Practice address
96 E Kimballs LN Ste 408
Draper, UT 84020-5021
Phone
(801) 572-1186
NPI assigned
Nov 12, 2018
Last updated
Feb 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Authorized official

Name
Jeremy Joyal, MDNPI 1861622219
Title
Member
Phone
(801) 989-8660

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X Primary

Addresses

Primary practice location

96 E Kimballs LN Ste 408
Draper, UT 84020-5021

Mailing address

96 E Kimballs LN Ste 408
Draper, UT 84020-5021
Phone (801) 572-1186

Other practice location 1

1209 N Main St Ste B
Tooele, UT 84074-9841
Phone (801) 572-1186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190419000047 UT Part B Supplier - Clinic/Group Practice 4183966278 Receives reassigned benefits from 14 practitioners
Practice locations: Draper, UT; Tooele, UT

National Provider Directory

National Provider Directory

Locations

11760 S 700 E
Ste 112
Draper, UT 84020
Phone (801) 572-1186

1757 W Antelope Dr
Layton, UT 84041

1209 N Main St
#B
Tooele, UT 84074
Phone (435) 775-8086

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1437627080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 E KIMBALLS LN STE 408",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205021",
            "telephone_number": "801-572-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 E KIMBALLS LN STE 408",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205021",
            "telephone_number": "801-572-1186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1209 N Main St Ste B",
            "address_purpose": "LOCATION",
            "city": "Tooele",
            "state": "UT",
            "postal_code": "840749841",
            "country_code": "US",
            "telephone_number": "801-572-1186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED SPINE AND PAIN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-12",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "JOYAL",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "801-989-8660",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.