Pain Centers of Wisconsin-Green Bay, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PAIN CENTERS OF WISCONSIN-GREEN BAY, LLC

Practice address

2595 Development Dr
Ste 150
Green Bay, WI 54311

Phone

(414) 325-7246

NPI assigned

Feb 9, 2009

Last updated

Oct 24, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

APM, MSO, LLCAs reported in NPPES

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

Authorized official

Name

Vishal Lal

Title

Ceo

Phone

(414) 325-7246

Specialties & licenses 1

Addresses

Part of

Advanced Pain Management SC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  dba Prevea Health-CMH DME Supplier

  • Durable Medical Equipment & Medical Supplies
  • Oconto Falls, WI
  • NPI 1700203452

  Member Of

  NPD member

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477267200000",
    "number": "1750520193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 W LOOMIS RD",
            "address_2": "STE 300",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "53221",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2595 DEVELOPMENT DR",
            "address_2": "STE 150",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54311",
            "telephone_number": "414-325-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CENTERS OF WISCONSIN-GREEN BAY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "APM, MSO, LLC",
        "enumeration_date": "2009-02-09",
        "last_updated": "2016-10-24",
        "status": "A",
        "authorized_official_last_name": "LAL",
        "authorized_official_first_name": "VISHAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "414-325-7246"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly S Pagel, RN
• Mona E Pagel, MSW, APSW, LCSW
• Allison Pahl, MS, LAT, ATC
• Melanie Paider, FNP-C
• Pain Centers of Wisconsin-Green Bay, LLC
• Bethany Paiser, DC
• Brian E Palevac, DC
• Reynaldo V Palines, MD
• Palmer Counseling, LLC
• Jeffrey L Palmer, MSW

• Ambulatory Surgical Clinic/Center in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Ambulatory Surgical Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.