NPIMap

Organization Active NPI

Interventional Pain Management PC

  • Pain Medicine (Anesthesiology) Physician
  • Omaha, NE
National Provider Identifier
1497898621
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
INTERVENTIONAL PAIN MANAGEMENT PC
Practice address
9015 Arbor St
#155
Omaha, NE 68124-2056
Phone
(402) 384-2600
Fax
(402) 384-2606
NPI assigned
Feb 15, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Shawn J Pettis, M.D.NPI 1659421543
Title
President
Phone
(402) 384-2600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

9015 Arbor St
#155
Omaha, NE 68124-2056

Mailing address

9015 Arbor St
#155
Omaha, NE 68124-2056
Phone (402) 384-2600

National Provider Directory

National Provider Directory

Locations

7710 Mercy Rd
#606
Omaha, NE 68124
Phone (402) 397-4144

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497898621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9015 ARBOR ST",
            "address_2": "#155",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242056",
            "telephone_number": "402-384-2600",
            "fax_number": "402-384-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9015 ARBOR ST",
            "address_2": "#155",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242056",
            "telephone_number": "402-384-2600",
            "fax_number": "402-384-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL PAIN MANAGEMENT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETTIS",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-384-2600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.