Organization Active NPI

Cutting Edge Integrative Pain Centers LLC

  • Internal Medicine Physician
  • Elkhart, IN
National Provider Identifier
1790215168
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CUTTING EDGE INTEGRATIVE PAIN CENTERS LLC
Practice address
242 Waterfall Dr Ste B
Elkhart, IN 46516
Phone
(574) 389-7737
Fax
(574) 389-3196
NPI assigned
Jun 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Authorized official

Name
Orlando Landrum, MDNPI 1932159910
Title
Owner
Phone
(574) 389-7737

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
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

242 Waterfall Dr Ste B
Elkhart, IN 46516

Mailing address

242 Waterfall Dr Ste B
Elkhart, IN 46516-3647
Phone (574) 389-7737

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180720002557 IN Part B Supplier - Clinic/Group Practice 1355698309 Receives reassigned benefits from 1 practitioner
Practice locations: Elkhart, IN

National Provider Directory

National Provider Directory

Locations

242 Waterfall Dr
Ste B
Elkhart, IN 46516
Phone (574) 389-7737

3060 Windsor Ct
Elkhart, IN 46514
Phone (574) 389-7737

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526947200000",
    "number": "1790215168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 WATERFALL DR STE B",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465163647",
            "telephone_number": "574-389-7737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 WATERFALL DR STE B",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "46516",
            "telephone_number": "574-389-7737",
            "fax_number": "574-389-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUTTING EDGE INTEGRATIVE PAIN CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-18",
        "last_updated": "2018-05-22",
        "status": "A",
        "authorized_official_last_name": "LANDRUM",
        "authorized_official_first_name": "ORLANDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-389-7737",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; 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.