NPIMap

Organization Active NPI

Center for Interventional Pain Spine LLC

  • Durable Medical Equipment & Medical Supplies
  • Bryn Mawr, PA
National Provider Identifier
1619320553
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
CENTER FOR INTERVENTIONAL PAIN SPINE LLC
Practice address
931 E Haverford Rd Ste 202
Bryn Mawr, PA 19010-3838
Phone
(844) 365-7246
Fax
(610) 525-8201
NPI assigned
Jul 15, 2016
Last updated
Nov 30, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTER FOR INTERVENTIONAL PAIN SPINE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Authorized official

Name
Ms. Stefanie Paulus
Title
Business Manager
Phone
(302) 477-1706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

931 E Haverford Rd Ste 202
Bryn Mawr, PA 19010-3838

Mailing address

223 Wilmington W Chester Pike Ste 214
Chadds Ford, PA 19317-9007
Phone (844) 365-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210304001481 PA DME Supplier - Physician - Interventional Pain Management 6507040078 Practice locations: Bryn Mawr, PA

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Center for Inter Pain Spine20 organizations share this tax ID, including this one
Part of
Center for Inter Pain Spine

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

3401 Brandywine Pkwy
Wilmington, DE 19803

NPI Registry JSON

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606694400000",
    "number": "1619320553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 WILMINGTON W CHESTER PIKE STE 214",
            "city": "CHADDS FORD",
            "state": "PA",
            "postal_code": "193179007",
            "telephone_number": "844-365-7246",
            "fax_number": "103-617-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 E HAVERFORD RD STE 202",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103838",
            "telephone_number": "844-365-7246",
            "fax_number": "610-525-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR INTERVENTIONAL PAIN SPINE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTER FOR INTERVENTIONAL PAIN SPINE LLC",
        "enumeration_date": "2016-07-15",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A",
        "authorized_official_last_name": "PAULUS",
        "authorized_official_first_name": "STEFANIE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "302-477-1706",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.