Active NPI
Jerseyville Pain Management Center, S.C.
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Wood River, IL
National Provider Identifier
1811262728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- License
- 36048379
- Legal business name
- JERSEYVILLE PAIN MANAGEMENT CENTER, S.C.
- Practice address
- 1702 Vaughn Rd
Wood River, IL 62095-1898 - Phone
- (618) 259-3321
- NPI assigned
- Mar 12, 2012
- Last updated
- Mar 12, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. James A Briggs, D.C.
- Title
- President
- Phone
- (618) 259-3321
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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038009545 | IL | |
| Chiropractor | 111N00000X | 038004303 | IL | |
| Pain Medicine (Physical Medicine & Rehabilitation) Physician | 2081P2900X | 36048379 | IL | Primary |
| Interventional Pain Medicine Physician | 208VP0014X | 36048379 | IL | |
| Physical Therapist | 225100000X | 70004750 | IL |
Addresses
Primary practice location
1702 Vaughn Rd
Wood River, IL 62095-1898
Mailing address
PO Box 649
Wood River, IL 62095-0649
Phone (618) 259-3321
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04232007 | Other | IL | BCBS ILLINOIS |
| 224252 | Other | GHP | |
| 5933000001 | Other | IL | MEDICARE P-TAN |
| 038009545 | Medicaid | IL | |
| 477779 | Other | IL | HEALTHLINK |
| 210609 | Other | IL | MEDICARE ILLINOIS |
National Provider Directory
National Provider Directory- Tax ID family
- Jerseyville Pain Management
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Non-Pharmacy Dispensing Site
- Wood River, IL
- NPI 1255609574
Locations
1702 Vaughn Rd
Wood River, IL 62095
Phone (618) 259-3321
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Chiropractor
- Jerseyville, IL
- NPI 1386604643
-
- Physical Therapist
- Bethalto, IL
- NPI 1922061233
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331510400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1331510400000",
"number": "1811262728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 649",
"city": "WOOD RIVER",
"state": "IL",
"postal_code": "620950649",
"telephone_number": "618-259-3321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1702 VAUGHN RD",
"city": "WOOD RIVER",
"state": "IL",
"postal_code": "620951898",
"telephone_number": "618-259-3321"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JERSEYVILLE PAIN MANAGEMENT CENTER, S.C.",
"organizational_subpart": "NO",
"enumeration_date": "2012-03-12",
"last_updated": "2012-03-12",
"status": "A",
"authorized_official_last_name": "BRIGGS",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "618-259-3321",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038009545",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038004303",
"primary": false
},
{
"code": "2081P2900X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Pain Medicine",
"state": "IL",
"license": "36048379",
"primary": true
},
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "IL",
"license": "36048379",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "70004750",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS ILLINOIS",
"identifier": "04232007",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHP",
"identifier": "224252",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE P-TAN",
"identifier": "5933000001",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "038009545",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "477779",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ILLINOIS",
"identifier": "210609",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wood River, IL
- Tiffany Iberg, BC-HIS
- In Situ Counseling & Coaching LLC
- Denise Marie Jacquin, O.D.
- Jerseyville Pain Management Center, S.C.
- Jerseyville Pain Management Center, S.C.
- JKH Management, LLC (Apex Physical Therapy)
- Johnson's Auditory Sales & Service, Inc. (Johnson's Hearing Center)
- Johnson's Auditory Sales & Service, Inc. (Johnson's Hearing Center)
- Brandon Christopher Kopp, PHARMD
- Angelina M Leitschuh, NP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.