Physicians Pain and Spine Specialists

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

18988 Issued in MS

Legal business name

PHYSICIANS PAIN AND SPINE SPECIALISTS

Practice address

14986 Angela Dr
Gulfport, MS 39503-3502

Phone

(228) 357-5464

Fax

(877) 563-0603

NPI assigned

Jan 23, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Shawn X Wu, MDNPI 1952462905

Title

Medical Director

Phone

(248) 342-5207

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shawn X Wu, MD

  • Interventional Pain Medicine Physician
  • Gulfport, MS
  • NPI 1952462905
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610928000000",
    "number": "1639417819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14986 ANGELA DR",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033502",
            "telephone_number": "228-357-5464",
            "fax_number": "877-563-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14986 ANGELA DR",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033502",
            "telephone_number": "228-357-5464",
            "fax_number": "877-563-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS PAIN AND SPINE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-23",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "X",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "248-342-5207",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MS",
            "license": "18988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05482375",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phoenix Independent Living Inc
• Phoenix Independent Living Inc
• Phyllis L Dickerson LCSW
• Physical Therapy Clinic of Gulfport
• Physicians Care Plaza, LLC
• Christopher Scott Pickreign
• Gregory Kevin Picou, D.C.
• Samantha C Pierce, OTR/L
• Brittany Leann Pipkins, FNP-C
• Stephen Pisarich

• Interventional Pain Medicine Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Interventional Pain Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.