NPIMap

Organization Active NPI

Spine Pain and Rehab Associates LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Blue Springs, MO
National Provider Identifier
1780157172
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
SPINE PAIN AND REHAB ASSOCIATES LLC
Practice address
201 NW R D Mize Rd
Blue Springs, MO 64014-2513
Phone
(816) 655-5270
NPI assigned
Jan 8, 2019
Last updated
Jun 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Authorized official

Name
Mohsen Tahani, MDNPI 1235441619
Title
Owner
Phone
(816) 655-5270

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
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X Primary

Addresses

Primary practice location

201 NW R D Mize Rd
Blue Springs, MO 64014-2513

Mailing address

4125 State Line Rd
Kansas City, MO 64111-4423
Phone (818) 300-2998

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190228001593 MO Part B Supplier - Clinic/Group Practice 6709125255 Receives reassigned benefits from 15 practitioners
Practice locations: Kansas City, MO; Independence, MO; Blue Springs, MO

National Provider Directory

National Provider Directory

Locations

801 NW Saint Mary Dr
Ste 210
Blue Springs, MO 64014
Phone (816) 200-1533

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560902400000",
    "number": "1780157172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 STATE LINE RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641114423",
            "telephone_number": "818-300-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 NW R D MIZE RD",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640142513",
            "telephone_number": "816-655-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE PAIN AND REHAB ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-08",
        "last_updated": "2019-06-19",
        "status": "A",
        "authorized_official_last_name": "TAHANI",
        "authorized_official_first_name": "MOHSEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-655-5270",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Springs, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.