Pain Management of Westville

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

PAIN MANAGEMENT OF WESTVILLE

Doing business as

Pain Management

Practice address

419 S Williams Avenue
Westville, OK 74965

Phone

(918) 512-1462

Fax

(918) 512-1538

NPI assigned

Apr 17, 2019

Last updated

Oct 24, 2019By 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

Lisa Simpson

Title

Manager

Phone

(918) 512-1462

Specialties & licenses 3

Addresses

Other names 1

• Pain Management Doing business as

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571875200000",
    "number": "1790348522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 S WILLIAMS AVENUE",
            "city": "WESTVILLE",
            "state": "OK",
            "postal_code": "74965",
            "telephone_number": "918-512-1462",
            "fax_number": "918-512-1538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 S WILLIAMS AVENUE",
            "city": "WESTVILLE",
            "state": "OK",
            "postal_code": "74965",
            "telephone_number": "918-512-1462",
            "fax_number": "918-512-1538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 W Quesenbury Ave",
            "address_purpose": "LOCATION",
            "city": "Sallisaw",
            "state": "OK",
            "postal_code": "749553613",
            "country_code": "US",
            "telephone_number": "918-235-6877",
            "fax_number": "918-512-1538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PAIN MANAGEMENT OF WESTVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-17",
        "last_updated": "2019-10-24",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "918-512-1462"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain Management",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pain Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Misty Mahler
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• Charles Cornelius Pastoor, MA
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• Jennifer Ann Robin

• Pain Medicine (Anesthesiology) Physician in Westville, OK
• Providers in Westville, OK by specialty
• Pain Medicine (Anesthesiology) Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.