Indiana Spine & Pain Institute PC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

INDIANA SPINE & PAIN INSTITUTE PC

Practice address

4411 Washington Ave Ste 100
Evansville, IN 47714-0805

Phone

(312) 637-9861

Fax

(770) 573-9513

NPI assigned

Nov 22, 2017

Last updated

May 31, 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

Mansoor A Khan, MD

Title

Owner

Phone

(812) 803-2312

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559260800000",
    "number": "1811401136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 WASHINGTON AVE STE 100",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140805",
            "telephone_number": "812-437-7246",
            "fax_number": "812-402-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 WASHINGTON AVE STE 100",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140805",
            "telephone_number": "312-637-9861",
            "fax_number": "770-573-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA SPINE & PAIN INSTITUTE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-22",
        "last_updated": "2019-05-31",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MANSOOR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-803-2312",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Indiana Hearing LLC (Miracle Ear)
• Indiana Hearing LLC (Miracle Ear)
• Indiana MRI of Evansville, LLC
• Indiana Outpatient Services, P.C.
• Indiana Pain Centers-Evansville LLC
• Infectious Diseases and Travel
• Kaycee G Inge, LCSW
• Lisa A Ingler, OTR
• Courtney Ingold, MT-BC
• Inhome Connect of Southwest Indiana, LLC

• Interventional Pain Medicine Physician in Evansville, IN
• Providers in Evansville, IN by specialty
• Interventional Pain Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.