NPIMap

Organization Active NPI

Indiana Pain and Spine Care

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Plainfield, IN
National Provider Identifier
1568444586
Registry record updated Oct 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
INDIANA PAIN AND SPINE CARE
Practice address
1100 Southfield Dr
Suite 1330
Plainfield, IN 46168-4498
Phone
(317) 837-1999
Fax
(317) 837-0233
NPI assigned
Nov 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2009

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

Authorized official

Name
Dr. Van Evanoff Jr., M.D.NPI 1851394175
Title
Owner
Phone
(317) 837-1999

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 (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X IN Primary

Addresses

Primary practice location

1100 Southfield Dr
Suite 1330
Plainfield, IN 46168-4498

Mailing address

1100 Southfield Dr
Suite 1330
Plainfield, IN 46168-4498
Phone (317) 837-1999

Other identifiers 1

IdentifierTypeStateIssuer
200496300AMedicaidIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254960000000",
    "number": "1568444586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SOUTHFIELD DR",
            "address_2": "SUITE 1330",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461684498",
            "telephone_number": "317-837-1999",
            "fax_number": "317-837-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SOUTHFIELD DR",
            "address_2": "SUITE 1330",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461684498",
            "telephone_number": "317-837-1999",
            "fax_number": "317-837-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA PAIN AND SPINE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2009-10-08",
        "status": "A",
        "authorized_official_last_name": "EVANOFF",
        "authorized_official_first_name": "VAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-837-1999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200496300A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; 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.