Southeastern Interventional Pain Physicians, P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SOUTHEASTERN INTERVENTIONAL PAIN PHYSICIANS, P.A.

Doing business as

Emerald Coast Pain Physicians

Practice address

151 Mary Esther Blvd
Suite 303
Mary Esther, FL 32569-1972

Phone

(850) 243-7788

Fax

(850) 243-7738

NPI assigned

Apr 26, 2006

Organization subpart

No

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

Authorized official

Name

Patricia Newsom

Title

Medical Biller

Phone

(850) 243-7788

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• EMERALD COAST PAIN PHYSICIANS Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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

• Lamvien Quoc Nguyen, M.D.

  • Specialist
  • Mary Esther, FL
  • NPI 1285691782
  Medicare reassignment NPD
• Gregory Paul Staviski, M.D.

  • Specialist
  • Mary Esther, FL
  • NPI 1619934379
  Medicare reassignment NPD
• Stephanie Petrina Noack, M.D.

  • Anesthesiology Physician
  • Murfreesboro, TN
  • NPI 1093855306
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700843513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325620699",
            "telephone_number": "850-243-7788",
            "fax_number": "850-243-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MARY ESTHER BLVD",
            "address_2": "SUITE 303",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325691972",
            "telephone_number": "850-243-7788",
            "fax_number": "850-243-7738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN INTERVENTIONAL PAIN PHYSICIANS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NEWSOM",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "MEDICAL BILLER",
        "authorized_official_telephone_number": "850-243-7788"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "45117",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EMERALD COAST PAIN PHYSICIANS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Ann Simmons, PHARMD
• Joseph P. Skelly, M.S., L.M.H.C.
• Sleep Disorder Center Ft Walton Beach Inc
• Sara Smidt
• Timothy B. Smith, H.A.S.
• Niki Lee Spears, RBT
• Gregory Paul Staviski, M.D.
• Stepping Stones Professional Counseling, Inc.
• Amanda Kay Sternke, RBT
• Rebecca Stevens

• Specialist in Mary Esther, FL
• Providers in Mary Esther, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.