The Spine and Pain Center LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

THE SPINE AND PAIN CENTER LLC

Practice address

1919 S Wheeling Ave Ste 204
Tulsa, OK 74104-5631

Phone

(918) 727-7246

NPI assigned

Dec 3, 2018

Organization subpart

No

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

Authorized official

Name

Adam Wallace, MDNPI 1518129733

Title

Owner

Phone

(918) 727-7246

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 12

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

• Adam Joseph Wallace, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Tulsa, OK
  • NPI 1518129733

  OK, Pain Medicine

  Medicare reassignment Care Compare group NPD Authorized official
• Susan Mitchell, APRN-CNP

  • Nurse Practitioner
  • Tulsa, OK
  • NPI 1013452499

  OK

  Medicare reassignment Care Compare group NPD
• Brian Thomas Torgerson, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Tulsa, OK
  • NPI 1194928283

  OK, Pain Medicine

  Medicare reassignment Care Compare group NPD
• Amy Foreman

  • Clinical Social Worker
  • Tulsa, OK
  • NPI 1396154704

  OK

  Medicare reassignment Care Compare group
• Kendra Joy Hurst, PA-C

  • Physician Assistant
  • Tulsa, OK
  • NPI 1346273638

  OK

  Medicare reassignment Care Compare group
• Luke Schumacher, PA-C

  • Physician Assistant
  • Tulsa, OK
  • NPI 1811357411

  OK

  Medicare reassignment Care Compare group
• Marco NMN Criscione, NP

  • Nurse Practitioner
  • Jenks, OK
  • NPI 1134645922

  OK

  Medicare reassignment NPD
• Aikaterini Fausnaught, FNP-C

  • Family Nurse Practitioner
  • Bartlesville, OK
  • NPI 1841014891

  OK

  Medicare reassignment NPD
• Aliyeah Roper, D.O.

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1386955532

  OK

  Medicare reassignment NPD
• Vishal Aggarwal, MD

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1295705663
  NPD (past)
• Kala Marie Gaydos, APRN-CNP

  • Nurse Practitioner
  • Tulsa, OK
  • NPI 1972876191
  NPD (past)
• Ashton Danielle Peterson

  • Family Nurse Practitioner
  • Broken Arrow, OK
  • NPI 1992263453
  NPD (past)

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761868800000",
    "number": "1689144602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE STE 204",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE STE 204",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045631",
            "telephone_number": "918-727-7246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3336 E 32nd St Ste 220",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741354442",
            "country_code": "US",
            "telephone_number": "918-255-7246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE SPINE AND PAIN CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-03",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-727-7246",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Tulsa, OK
• Pain Medicine (Anesthesiology) Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; 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.