Pain Management Center of Southern Indiana

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

PAIN MANAGEMENT CENTER OF SOUTHERN INDIANA

Practice address

275 W 12TH St
Suite 206
Peru, IN 46970-1638

Phone

(812) 824-5690

Fax

(812) 824-5692

NPI assigned

Nov 12, 2009

Organization subpart

No

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

Authorized official

Name

Kamal K. Tiwari, MD

Title

Owner

Phone

(812) 333-7246

Specialties & licenses 2

Addresses

Other identifiers 1

Tax ID family

Pain Management Center of Southern Indiana2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pain Management Center of Southern Indiana

  • Pain Medicine Physician
  • Bloomfield, IN
  • NPI 1417284415
  NPD tax ID

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258070400000",
    "number": "1720315781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 S ROCKPORT RD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474039765",
            "telephone_number": "812-333-7246",
            "fax_number": "812-333-4471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W 12TH ST",
            "address_2": "SUITE 206",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469701638",
            "telephone_number": "812-824-5690",
            "fax_number": "812-824-5692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MANAGEMENT CENTER OF SOUTHERN INDIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-12",
        "last_updated": "2009-11-13",
        "status": "A",
        "authorized_official_last_name": "TIWARI",
        "authorized_official_first_name": "KAMAL",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-333-7246",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100389270",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Dondi Nelson
• Grace Nightingale, RBT
• Tammerrie Ann Nolen
• Chase Allen-Tobias Ogle
• Elaine Olson
• Bella Panmei
• Danielle Nicole Parker, RN
• Parkview Logansport Hospital, Inc.
• Peace of Mind, LLC
• Peaceful Pathways LLC

• Pain Medicine Physician in Peru, IN
• Providers in Peru, IN by specialty
• Pain Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.