NPIMap

Organization Active NPI

Premium Interventional Pain Management Center PLLC

  • Interventional Pain Medicine Physician
  • Houston, TX
National Provider Identifier
1568816031
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
PREMIUM INTERVENTIONAL PAIN MANAGEMENT CENTER PLLC
Practice address
2105 Jackson St
1St Floor
Houston, TX 77003-5839
Phone
(732) 952-5533
NPI assigned
Apr 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2016

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

Authorized official

Name
Adity Sharma, M.D.
Title
Medical Director
Phone
(732) 952-5533

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

2105 Jackson St
1St Floor
Houston, TX 77003-5839

Mailing address

26 Throckmorton LN
2ND FL
Old Bridge, NJ 08857-2520
Phone (732) 952-5533

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1568816031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 THROCKMORTON LN",
            "address_2": "2ND FL",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572520",
            "telephone_number": "732-952-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 JACKSON ST",
            "address_2": "1ST FLOOR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770035839",
            "telephone_number": "732-952-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM INTERVENTIONAL PAIN MANAGEMENT CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-20",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "ADITY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "732-952-5533",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.