Cleveland Back & Pain Management Center Inc.

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

35051581 Issued in OH

Legal business name

CLEVELAND BACK & PAIN MANAGEMENT CENTER INC.

Practice address

2307 W 14TH St
Cleveland, OH 44113-3612

Phone

(216) 687-4003

Fax

(216) 687-4069

NPI assigned

Aug 16, 2006

Last updated

Mar 5, 2012By 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

Dr. John Harvey Nickels, MD

Title

Director/ Officer

Phone

(216) 687-4003

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• John A Kostoglou, DC

  • Chiropractor
  • Parma, OH
  • NPI 1235203019
  NPD (past)
• Steven V Kozmary, MD

  • Pain Medicine (Anesthesiology) Physician
  • Las Vegas, NV
  • NPI 1659337459
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330905600000",
    "number": "1669585428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 W 14TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441133612",
            "telephone_number": "216-687-4003",
            "fax_number": "216-687-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 W 14TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441133612",
            "telephone_number": "216-687-4003",
            "fax_number": "216-687-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND BACK & PAIN MANAGEMENT CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2012-03-05",
        "status": "A",
        "authorized_official_last_name": "NICKELS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "HARVEY",
        "authorized_official_title_or_position": "DIRECTOR/ OFFICER",
        "authorized_official_telephone_number": "216-687-4003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OH",
            "license": "35051581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2802695",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Anesthesiology) Physician in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Pain Medicine (Anesthesiology) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; 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.