Organization Active NPI

Barrett Pain Associates, Inc

  • Pain Medicine Physician
  • Dover, OH
National Provider Identifier
1710180450
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
BARRETT PAIN ASSOCIATES, INC
Practice address
844 Boulevard St
Dover, OH 44622-2008
Phone
(330) 473-6615
Fax
(330) 365-9970
NPI assigned
Jun 8, 2007
Last updated
Jan 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Shelley J Shane
Title
Office Manager
Phone
(330) 473-6615

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X NU Primary

Addresses

Primary practice location

844 Boulevard St
Dover, OH 44622-2008

Mailing address

844 Boulevard St
Dover, OH 44622-2008
Phone (330) 473-6615

Other identifiers 1

IdentifierTypeStateIssuer
2791680MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070705000363 OH Part B Supplier - Clinic/Group Practice 5294835237 Receives reassigned benefits from 6 practitioners
Practice locations: Millersburg, OH; Dover, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D1099909Barrett Pain Associates Inc844 Boulevard Street, Dover, OH 44622Certificate of waiverMay 25, 2027

National Provider Directory

National Provider Directory

Locations

844 Boulevard St
Dover, OH 44622
Phone (330) 473-6615

Practitioners & affiliated clinicians

Practitioners 66

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.

View all 66

NPI Registry JSON

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1710180450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 BOULEVARD ST",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222008",
            "telephone_number": "330-473-6615",
            "fax_number": "330-365-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 BOULEVARD ST",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222008",
            "telephone_number": "330-473-6615",
            "fax_number": "330-365-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARRETT PAIN ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-08",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "SHANE",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "330-473-6615"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2791680",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.