The Pain Management Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

THE PAIN MANAGEMENT CLINIC

Practice address

730 S Woodruff Ave
Idaho Falls, ID 83401-5285

Phone

(208) 542-9111

Fax

(208) 542-9114

NPI assigned

Feb 15, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Candace Marie Bunnage

Title

Billing Manager

Phone

(208) 542-9111

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1780727818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834015285",
            "telephone_number": "208-542-9111",
            "fax_number": "208-542-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834015285",
            "telephone_number": "208-542-9111",
            "fax_number": "208-542-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PAIN MANAGEMENT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BUNNAGE",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "208-542-9111",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Idaho Falls Village)
• The Evangelical Lutheran Good Samaritan Society (Idaho Falls Good Samaritan)
• The Genshai Trauma Recovery Center
• The Idaho Children's Rehabilitation Center
• The Living Farm, PC
• The Sleep Institute
• Therapeutic House Calls, P.a. (Therapeutic House Calls)
• Therapeutic Shoes Inc
• Therapeutic Solutions
• Natalie M Theriault, L.AC

• Family Medicine Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.