NPIMap

Organization Active NPI

Paincare PA

  • Pain Medicine Physician
  • Overland Park, KS
National Provider Identifier
1811933716
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
PAINCARE PA
Practice address
10501 Metcalf Ave
Overland Park, KS 66212-1815
Phone
(913) 901-8880
Fax
(913) 901-8898
NPI assigned
Jun 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Authorized official

Name
Kimber EubanksNPI 1053395673
Title
MD
Phone
(913) 901-8880

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208VP0000X Primary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X

Addresses

Primary practice location

10501 Metcalf Ave
Overland Park, KS 66212-1815

Mailing address

10501 Metcalf Ave
Overland Park, KS 66212-1815
Phone (913) 901-8880

Other identifiers 1

IdentifierTypeStateIssuer
CJ8534OtherKSRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090511000131 KS Part B Supplier - Clinic/Group Practice 3779492798 Receives reassigned benefits from 9 practitioners
Practice locations: Shawnee Mission, KS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D2073424Paincare10501 Metcalf Avenue, Overland Park, KS 66212Certificate of waiverFeb 17, 2028

National Provider Directory

National Provider Directory

Locations

5701 W 119th St
Ste 102
Overland Park, KS 66209
Phone (816) 444-9000

10501 Metcalf Ave
Shawnee Mission, KS 66212
Phone (913) 754-0340

Practitioners & affiliated clinicians

Practitioners 9

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": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1811933716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10501 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662121815",
            "telephone_number": "913-901-8880",
            "fax_number": "913-901-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10501 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662121815",
            "telephone_number": "913-901-8880",
            "fax_number": "913-901-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAINCARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "EUBANKS",
        "authorized_official_first_name": "KIMBER",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "913-901-8880"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CJ8534",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.