Community Pain Management Medical Clinic Inc

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

A32046 Issued in CA

Legal business name

COMMUNITY PAIN MANAGEMENT MEDICAL CLINIC INC

Practice address

4500 Brockton Ave
Ste 305
Riverside, CA 92501-4028

Phone

(951) 715-3963

Fax

(951) 715-3960

NPI assigned

Jun 15, 2005

Last updated

Apr 20, 2008By 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

Dr. Jan Paul Maddox, M.D.,FIPP,ABA,ABPMNPI 1699770974

Title

Medical Director

Phone

(951) 715-3963

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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.

• Jan Paul Maddox, M.D.

  • Interventional Pain Medicine Physician
  • Riverside, CA
  • NPI 1699770974
  Authorized official Same address or phone
• Vance Murray Snyder, P.A.

  • Medical Physician Assistant
  • Van Nuys, CA
  • NPI 1659591873
  NPD (past)

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1811992068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1509",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925021509",
            "telephone_number": "951-715-3963",
            "fax_number": "951-715-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 BROCKTON AVE",
            "address_2": "STE 305",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014028",
            "telephone_number": "951-715-3963",
            "fax_number": "951-715-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PAIN MANAGEMENT MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MADDOX",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "951-715-3963",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,FIPP,ABA,ABPM"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A32046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL ID NUMBER",
            "identifier": "00A320460",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ID",
            "identifier": "ZZZ05981Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community Health Systems, Inc. (CHSI Mobile Wellness Clinic #2)
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• Community Health Systems, Inc. (CHSI Mobile Wellness Clinic #1)
• Community Medical Group of Riverside Inc
• Companion Home Health Inc.
• Companion Hospice, LLC
• Compassion Care Health Center Inc
• Compassion Compass Therapy Licensed Clinical Social Worker PC
• Compassionate Journey Non Emergency Transport LLC

• Interventional Pain Medicine Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Interventional Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.