NPIMap

Organization Active NPI

Colorado Institute for Pain Management LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Colorado Springs, CO
National Provider Identifier
1447643127
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
30232 Issued in CO
Legal business name
COLORADO INSTITUTE FOR PAIN MANAGEMENT LLC
Practice address
3910 S Carefree Cir Ste C
Colorado Springs, CO 80917-3053
Phone
(719) 599-5753
Fax
(719) 599-5817
NPI assigned
Mar 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Authorized official

Name
Dr. John Mason Tyler Jr., M.D.
Title
Physician
Phone
(719) 599-5753

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 30232 CO
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X 30232 CO Primary

Addresses

Primary practice location

3910 S Carefree Cir Ste C
Colorado Springs, CO 80917-3053

Mailing address

3910 S Carefree Cir Ste C
Colorado Springs, CO 80917-3053
Phone (719) 599-5753

Other identifiers 3

IdentifierTypeStateIssuer
103200300OtherCODEPARTMENT OF LABOR PROVIDER ID
4489508OtherCOCIGNA PROVIDER ID
4489508OtherCOAETNA PROVIDER ID

Other names 1

  • John M Tyler Jr MD Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482105600000",
    "number": "1447643127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 S CAREFREE CIR STE C",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809173053",
            "telephone_number": "719-599-5753",
            "fax_number": "719-599-5817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 S CAREFREE CIR STE C",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809173053",
            "telephone_number": "719-599-5753",
            "fax_number": "719-599-5817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO INSTITUTE FOR PAIN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-05",
        "last_updated": "2016-12-19",
        "status": "A",
        "authorized_official_last_name": "TYLER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MASON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "719-599-5753",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": "30232",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CO",
            "license": "30232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR PROVIDER ID",
            "identifier": "103200300",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER ID",
            "identifier": "4489508",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "4489508",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John M Tyler Jr MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.