NPIMap

Organization Active NPI

Life Spring Pain Management, LLC

  • Health Service Clinic/Center
  • Kaysville, UT
National Provider Identifier
1699115188
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
5867369-1205 Issued in UT
Legal business name
LIFE SPRING PAIN MANAGEMENT, LLC
Practice address
275 W 200 N
Ste 7
Kaysville, UT 84037-1861
Phone
(801) 546-1300
NPI assigned
Jun 27, 2013
Last updated
Sep 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Authorized official

Name
Dr. Christian C Obah, MDNPI 1912959008
Title
Owner
Phone
(801) 786-9030

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 5867369-1205 UT Primary
Health Service Clinic/Center 261QH0100X 5867389-1205 UT

Addresses

Primary practice location

275 W 200 N
Ste 7
Kaysville, UT 84037-1861

Mailing address

275 W 200 N
Ste 7
Kaysville, UT 84037-1861
Phone (801) 546-1300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131023002412 UT Part B Supplier - Clinic/Group Practice 2567697931 Receives reassigned benefits from 9 practitioners
Practice locations: Kaysville, UT

National Provider Directory

National Provider Directory

Locations

275 W 200 N
Kaysville, UT 84037

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378166400000",
    "number": "1699115188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W 200 N",
            "address_2": "STE 7",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840371861",
            "telephone_number": "801-546-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W 200 N",
            "address_2": "STE 7",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840371861",
            "telephone_number": "801-546-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SPRING PAIN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-27",
        "last_updated": "2013-09-03",
        "status": "A",
        "authorized_official_last_name": "OBAH",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-786-9030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "UT",
            "license": "5867369-1205",
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "UT",
            "license": "5867389-1205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaysville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; 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.