NPIMap

Organization Active NPI

Advanced Spine and Pain LLC

  • Pain Medicine (Anesthesiology) Physician
  • Phoenix, AZ
National Provider Identifier
1639951577
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
ADVANCED SPINE AND PAIN LLC
Practice address
333 W Thomas Rd Ste 204
Phoenix, AZ 85013-4425
Phone
(480) 573-0130
Fax
(480) 573-0131
NPI assigned
Oct 16, 2023
Last updated
Oct 16, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVANCED SPINE AND PAIN LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Authorized official

Name
Jarrett Michael LeathemNPI 1205193109
Title
Owner
Phone
(860) 670-2412

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X NU Primary
Pain Medicine Physician 208VP0000X NU
Interventional Pain Medicine Physician 208VP0014X NU

Addresses

Primary practice location

333 W Thomas Rd Ste 204
Phoenix, AZ 85013-4425

Mailing address

2525 W Greenway Rd Ste 125
Phoenix, AZ 85023-4226
Phone (480) 573-0130

National Provider Directory

National Provider Directory
Part of
Advanced Spine and Pain LLC

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Locations

3655 W Anthem Way
#129
Anthem, AZ 85086

2330 N Alma School Rd
Ste 102
Chandler, AZ 85224
Phone (480) 775-4700

1510 E Wagon Wheel Ln
Ste 110
Fort Mohave, AZ 86426
Phone (904) 994-5560

2563 S Val Vista Dr
Ste 101B
Gilbert, AZ 85295

9401 W Thunderbird Rd
Ste 155
Peoria, AZ 85381
Phone (480) 659-7147

2525 W Greenway Rd
Ste 230
Phoenix, AZ 85023
Phone (480) 573-0886

2525 W Greenway Rd
Ste 240
Phoenix, AZ 85023
Phone (602) 942-1960

2525 W Greenway Rd
Ste 250
Phoenix, AZ 85023
Phone (602) 564-8688

7201 N Dreamy Draw Dr
Ste 200
Phoenix, AZ 85020

22719 S Ellsworth Rd
Ste 1010
Queen Creek, AZ 85142

12361 W Bola Dr
Ste 110
Surprise, AZ 85378
Phone (623) 977-1157

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1639951577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 W GREENWAY RD STE 125",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850234226",
            "telephone_number": "480-573-0130",
            "fax_number": "480-573-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W THOMAS RD STE 204",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134425",
            "telephone_number": "480-573-0130",
            "fax_number": "480-573-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPINE AND PAIN LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED SPINE AND PAIN LLC",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "LEATHEM",
        "authorized_official_first_name": "JARRETT",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-670-2412"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.