Organization Active NPI

Premier Pain Spine and Sports Medicine PC

  • Specialist
  • East Stroudsburg, PA
National Provider Identifier
1457789117
Registry record updated May 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD424898
Legal business name
PREMIER PAIN SPINE AND SPORTS MEDICINE PC
Practice address
391 East Brown Street
East Stroudsburg, PA 18301
Phone
(570) 241-9224
NPI assigned
Oct 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2014

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

Authorized official

Name
Mikhail Artamonov, M.D
Title
President
Phone
(570) 872-9800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X MD424898 Primary

Addresses

Primary practice location

391 East Brown Street
East Stroudsburg, PA 18301

Mailing address

391 East Brown Street
East Stroudsburg, PA 18301
Phone (570) 241-9224

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398988800000",
    "number": "1457789117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 EAST BROWN STREET",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "18301",
            "telephone_number": "570-241-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 EAST BROWN STREET",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "18301",
            "telephone_number": "570-241-9224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PAIN SPINE AND SPORTS MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-16",
        "last_updated": "2014-05-02",
        "status": "A",
        "authorized_official_last_name": "ARTAMONOV",
        "authorized_official_first_name": "MIKHAIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-872-9800",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": "MD424898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; 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.