Pro Pain LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

PRO PAIN LLC

Practice address

4800 Mexico Rd Ste 101
Saint Peters, MO 63376-1666

Phone

(636) 442-5035

NPI assigned

Feb 1, 2019

Last updated

Feb 1, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Scott BoedefeldNPI 1043299548

Title

Owner

Phone

(636) 442-5035

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Michael Scott Boedefeld, MD

  • Pain Medicine (Anesthesiology) Physician
  • Fenton, MO
  • NPI 1043299548
  Authorized official Same address or phone

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548979200000",
    "number": "1649735879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 MEXICO RD STE 101",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761666",
            "telephone_number": "636-442-5035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 MEXICO RD STE 101",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761666",
            "telephone_number": "636-442-5035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO PAIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-01",
        "last_updated": "2019-02-01",
        "status": "A",
        "authorized_official_last_name": "BOEDEFELD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-442-5035"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Preferred Family Healthcare, Inc. (Bridgeway Behavioral Health)
• Kayla Preiss
• Premium Adult Day Center LLC
• Stephanie Marie Prinster, DPT
• Pro Pain LLC
• Pro Pain LLC
• Kennay Lydia Lorene Proctor, M.S. CCC-SLP
• Professional Home Health Agency LLC
• Professional Physician Pain Services, LLC
• Professional Physicians Pain Services, LLC (Professional Pain Physicians)

• Pain Medicine (Anesthesiology) Physician in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Pain Medicine (Anesthesiology) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; 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.