NPIMap

Organization Active NPI

Spine & Sports Rehabilitation Institute

  • Pain Clinic/Center
  • Tempe, AZ
National Provider Identifier
1679906176
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
License
46748 Issued in AZ
Legal business name
SPINE & SPORTS REHABILITATION INSTITUTE
Practice address
2600 E. Southern Ave.
I-1
Tempe, AZ 85282-7738
Phone
(480) 420-3600
Fax
(480) 420-3644
NPI assigned
Aug 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Authorized official

Name
Dr. Paul S Sraow, M.D.NPI 1669634044
Title
Manager
Phone
(480) 420-3600

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 Clinic/Center 261QP3300X 46748 AZ Primary

Addresses

Primary practice location

2600 E. Southern Ave.
I-1
Tempe, AZ 85282-7738

Mailing address

2600 E. Southern Ave.
I-1
Tempe, AZ 85282-7738
Phone (480) 420-3600

Other names 2

  • East Valley Pain Management Doing business as
  • SSRI Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131004000317 AZ Part B Supplier - Clinic/Group Practice 2567696529 Receives reassigned benefits from 1 practitioner
Practice locations: Tempe, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609804800000",
    "number": "1679906176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 E. SOUTHERN AVE.",
            "address_2": "I-1",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827738",
            "telephone_number": "480-420-3600",
            "fax_number": "480-420-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 E. SOUTHERN AVE.",
            "address_2": "I-1",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827738",
            "telephone_number": "480-420-3600",
            "fax_number": "480-420-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE & SPORTS REHABILITATION INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-20",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "SRAOW",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-420-3600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "AZ",
            "license": "46748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Valley Pain Management",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSRI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.