Organization Active NPI

Advanced Pain Care Clinic PSC

  • Interventional Pain Medicine Physician
  • Vincennes, IN
National Provider Identifier
1730612698
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
ADVANCED PAIN CARE CLINIC PSC
Practice address
1813 Willow St Ste 3B
Vincennes, IN 47591
Phone
(812) 477-7246
Fax
(812) 477-7240
NPI assigned
Apr 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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

Authorized official

Name
Mahendra R Sanapati, MD
Title
President
Phone
(812) 214-4072

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

1813 Willow St Ste 3B
Vincennes, IN 47591

Mailing address

1101 Professional Blvd
Evansville, IN 47714-8016
Phone (812) 477-7246

Other practice location 1

545 Willow St
Vincennes, IN 47591-1064
Phone (812) 477-7246

Other identifiers 1

IdentifierTypeStateIssuer
200497580AMedicaidIN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535414400000",
    "number": "1730612698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 PROFESSIONAL BLVD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148016",
            "telephone_number": "812-477-7246",
            "fax_number": "812-477-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 WILLOW ST STE 3B",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "47591",
            "telephone_number": "812-477-7246",
            "fax_number": "812-477-7240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 Willow St",
            "address_purpose": "LOCATION",
            "city": "Vincennes",
            "state": "IN",
            "postal_code": "475911064",
            "country_code": "US",
            "telephone_number": "812-477-7246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED PAIN CARE CLINIC PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-07",
        "last_updated": "2018-08-28",
        "status": "A",
        "authorized_official_last_name": "SANAPATI",
        "authorized_official_first_name": "MAHENDRA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-214-4072",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200497580A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.