Organization Active NPI

Pain, Spine & Rehab.,a.S.C.,P.a.

  • Ambulatory Surgical Clinic/Center
  • Great Bend, KS
National Provider Identifier
1720332810
Registry record updated Oct 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
0431344 Issued in KS
Legal business name
PAIN, SPINE & REHAB.,A.S.C.,P.A.
Practice address
925 S Patton Rd
Suite B
Great Bend, KS 67530-4627
Phone
(620) 792-2991
Fax
(620) 792-3804
NPI assigned
Oct 29, 2012
Last updated
Oct 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2012

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

Authorized official

Name
Dr. Bell Mananirina Razafindrabe, M.D.NPI 1063414605
Title
Resident Agent
Phone
(620) 792-2991

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 0431344 KS Primary

Addresses

Primary practice location

925 S Patton Rd
Suite B
Great Bend, KS 67530-4627

Mailing address

925 S Patton Rd
Suite B
Great Bend, KS 67530-4627
Phone (620) 792-2991

Other identifiers 1

IdentifierTypeStateIssuer
200354350CMedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130325000543 KS Part B Supplier - Ambulatory Surgical Center 0749425643 Practice locations: Great Bend, KS

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Pain Spine and Rehab ASC PACCN 17C0001891
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

925 S Patton Rd
Ste B
Great Bend, KS 67530
Phone (620) 792-2991

Practitioners & affiliated clinicians

Practitioners 1

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": "1351468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351468800000",
    "number": "1720332810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 S PATTON RD",
            "address_2": "SUITE B",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675304627",
            "telephone_number": "620-792-2991",
            "fax_number": "620-792-3804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 S PATTON RD",
            "address_2": "SUITE B",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675304627",
            "telephone_number": "620-792-2991",
            "fax_number": "620-792-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN, SPINE & REHAB.,A.S.C.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-29",
        "last_updated": "2012-10-29",
        "status": "A",
        "authorized_official_last_name": "RAZAFINDRABE",
        "authorized_official_first_name": "BELL",
        "authorized_official_middle_name": "MANANIRINA",
        "authorized_official_title_or_position": "RESIDENT AGENT",
        "authorized_official_telephone_number": "620-792-2991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "KS",
            "license": "0431344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200354350C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Bend, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; 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.