NPIMap

Organization Active NPI

Elite Pain Solutions LLC

  • Pain Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1780816298
Registry record updated Aug 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
22361 Issued in OK
Legal business name
ELITE PAIN SOLUTIONS LLC
Practice address
3110 SW 89TH St
102
Oklahoma City, OK 73159-7920
Phone
(405) 703-4905
Fax
(405) 703-4980
NPI assigned
Aug 17, 2009
Last updated
Aug 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2017

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

Authorized official

Name
Miss Diann Phillips
Title
Business Office Generalist
Phone
(405) 703-4950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X 22361 OK Primary

Addresses

Primary practice location

3110 SW 89TH St
102
Oklahoma City, OK 73159-7920

Mailing address

3110 SW 89TH St
102
Oklahoma City, OK 73159-7920
Phone (405) 703-4905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110214000150 OK Part B Supplier - Clinic/Group Practice 5991985681 Receives reassigned benefits from 6 practitioners
Practice locations: Oklahoma City, OK
O20171219002795 OK DME Supplier - Physician - Physical and Rehabilitation 5991985681 Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1250467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502323200000",
    "number": "1780816298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 SW 89TH ST",
            "address_2": "102",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597920",
            "telephone_number": "405-703-4905",
            "fax_number": "405-703-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 SW 89TH ST",
            "address_2": "102",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597920",
            "telephone_number": "405-703-4905",
            "fax_number": "405-703-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PAIN SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-17",
        "last_updated": "2017-08-10",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "DIANN",
        "authorized_official_title_or_position": "BUSINESS OFFICE GENERALIST",
        "authorized_official_telephone_number": "405-703-4950",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "OK",
            "license": "22361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2017; 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.