Organization Active NPI

Pain Management Physicians, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Columbia, MO
National Provider Identifier
1679514087
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
PAIN MANAGEMENT PHYSICIANS, LLC
Practice address
1601 E Broadway
Lower Level
Columbia, MO 65201
Phone
(573) 815-2700
Fax
(573) 815-3693
NPI assigned
Jun 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Authorized official

Name
Steven Street, DONPI 1548296395
Title
Partner
Phone
(573) 815-2700

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

1601 E Broadway
Lower Level
Columbia, MO 65201

Mailing address

PO Box 7096
Stockton, CA 95267
Phone (209) 956-7725

Other identifiers 1

IdentifierTypeStateIssuer
501869903MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060317000128 MO Part B Supplier - Clinic/Group Practice 4082621941 Receives reassigned benefits from 1 practitioner
Practice locations: Springfield, MO

National Provider Directory

National Provider Directory

Locations

1502 E Broadway
Ste 106
Columbia, MO 65201
Phone (573) 443-4511

1506 E Broadway
Ste 302
Columbia, MO 65201
Phone (573) 449-1207

1601 E Broadway
Lowr
Columbia, MO 65201
Phone (573) 815-2700

3259 E Sunshine St
Ste Aa
Springfield, MO 65804
Phone (417) 416-4114

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331769600000",
    "number": "1679514087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95267",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E BROADWAY",
            "address_2": "LOWER LEVEL",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65201",
            "telephone_number": "573-815-2700",
            "fax_number": "573-815-3693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MANAGEMENT PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2012-03-15",
        "status": "A",
        "authorized_official_last_name": "STREET",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "573-815-2700",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "501869903",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.