Active NPI
Advanced Pain Care Clinic PSC
- Interventional Pain Medicine Physician
- Vincennes, IN
National Provider Identifier
1730612698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Pain Medicine Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Pain Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200497580A | Medicaid | IN |
National Provider Directory
National Provider DirectoryNPI 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.