NPIMap

Organization Active NPI

Pain Relief Associates LLC

  • Physical Therapy Clinic/Center
  • Saint Charles, MO
National Provider Identifier
1457521189
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PAIN RELIEF ASSOCIATES LLC
Practice address
190 Spring Dr
Saint Charles, MO 63303-3255
Phone
(636) 946-0799
Fax
(636) 946-3166
NPI assigned
Mar 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Authorized official

Name
Matthew J Wise
Title
Managing Member
Phone
(636) 946-0799

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

190 Spring Dr
Saint Charles, MO 63303-3255

Mailing address

PO Box 790126
Dept 10203
Saint Louis, MO 63179-0126
Phone (636) 600-1137

Other names 1

  • Breakthrough Pain Relief Clinic Doing business as

National Provider Directory

National Provider Directory

Member of 1

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

Locations

190 Spring Dr
Saint Charles, MO 63303
Phone (636) 389-6756

190 Spring Dr
Ste 300
Saint Charles, MO 63303
Phone (636) 946-0799

Practitioners & affiliated clinicians

Practitioners 5

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": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341187200000",
    "number": "1457521189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790126",
            "address_2": "DEPT 10203",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631790126",
            "telephone_number": "636-600-1137",
            "fax_number": "636-600-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 SPRING DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033255",
            "telephone_number": "636-946-0799",
            "fax_number": "636-946-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN RELIEF ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2012-07-02",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "636-946-0799"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breakthrough Pain Relief Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; 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.