NPIMap

Organization Active NPI

Innovative Pain and Wellness PLC

  • Pain Medicine (Anesthesiology) Physician
  • Phoenix, AZ
National Provider Identifier
1750064465
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
INNOVATIVE PAIN AND WELLNESS PLC
Practice address
1277 E Missouri Ave Ste 102
Phoenix, AZ 85014-2916
Phone
(480) 467-2273
NPI assigned
Aug 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Authorized official

Name
Daniel Karl Oconnor
Title
Owner
Phone
(480) 306-7242

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

1277 E Missouri Ave Ste 102
Phoenix, AZ 85014-2916

Mailing address

18511 N Scottsdale Rd Ste 202
Scottsdale, AZ 85255-9694
Phone (480) 306-7242

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231110001107 AZ DME Supplier - Physician - Anesthesiology 0840567111 Practice locations: Phoenix, AZ

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
03D2233942Innovative Pain & Wellness, PLC1277 E Missouri St Ste 102, Phoenix, AZ 85014AccreditationApr 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Innovative Pain and Wellness PLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1750064465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18511 N SCOTTSDALE RD STE 202",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852559694",
            "telephone_number": "480-306-7242",
            "fax_number": "480-306-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1277 E MISSOURI AVE STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142916",
            "telephone_number": "480-467-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE PAIN AND WELLNESS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "OCONNOR",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "KARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-306-7242"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.