NPIMap

Organization Active NPI

Pain Management Association, LLC

  • Interventional Pain Medicine Physician
  • Willoughby, OH
National Provider Identifier
1780772079
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
35071438D Issued in OH
Legal business name
PAIN MANAGEMENT ASSOCIATION, LLC
Practice address
6025 Commerce Cir
#2
Willoughby, OH 44094-9668
Phone
(440) 944-1414
Fax
(440) 944-1445
NPI assigned
Oct 11, 2006
Last updated
Aug 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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

Authorized official

Name
Dr. David Anthony Demangone, M.D.NPI 1548225832
Title
President
Phone
(440) 944-1414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X 35071438D OH Primary

Addresses

Primary practice location

6025 Commerce Cir
#2
Willoughby, OH 44094-9668

Mailing address

6035 Commerce Circle
#2
Willoughby, OH 44094
Phone (440) 944-1414

Other identifiers 1

IdentifierTypeStateIssuer
3016640MedicaidOH

National Provider Directory

National Provider Directory

Locations

6035 Commerce Cir
2
Willoughby, OH 44094

35040 Chardon Rd
Ste 210
Willoughby Hills, OH 44094
Phone (440) 602-9400

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313625600000",
    "number": "1780772079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6035 COMMERCE CIRCLE",
            "address_2": "#2",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "44094",
            "telephone_number": "440-944-1414",
            "fax_number": "440-944-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 COMMERCE CIR",
            "address_2": "#2",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440949668",
            "telephone_number": "440-944-1414",
            "fax_number": "440-944-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MANAGEMENT ASSOCIATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2011-08-18",
        "status": "A",
        "authorized_official_last_name": "DEMANGONE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-944-1414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "OH",
            "license": "35071438D",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3016640",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.