Integrative Pain Centres of Prescott

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

INTEGRATIVE PAIN CENTRES OF PRESCOTT

Practice address

2820 N Glassford Hill Rd Ste 101
Prescott Valley, AZ 86314-2256

Phone

(928) 910-3450

NPI assigned

Dec 22, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Dorian Norse Lange, R.PH.

Title

Ceo

Phone

(928) 910-3450

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1609264837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3769 CROSSINGS DRIVE",
            "address_2": "SUITE B",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86305",
            "telephone_number": "928-458-7343",
            "fax_number": "888-491-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 N GLASSFORD HILL RD STE 101",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142256",
            "telephone_number": "928-910-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE PAIN CENTRES OF PRESCOTT",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-22",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A",
        "authorized_official_last_name": "LANGE",
        "authorized_official_first_name": "DORIAN",
        "authorized_official_middle_name": "NORSE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-910-3450",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mysti Huston, MSN, APRN, FNP-BC
• Rondell K Huttmann, PHARMD
• Jane Miller Hynes
• Icare Health Services LLC
• Integrative Pain Centres of Prescott
• Internal Medicine Specialists of Prescott Valley Arizona,PC
• Krista Iverson, RN
• Lauraine M Jackson, FNP-BC
• Samantha Jacobson, PSYD
• Kavita Devi Jaikaran, DNP

• Ambulatory Surgical Clinic/Center in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.