Active NPI
Pain Relief Partners
- Physical Therapist
- Eureka, MO
National Provider Identifier
1821342619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2005031148
- Legal business name
- PAIN RELIEF PARTNERS
- Practice address
- 113 W 5TH St
Eureka, MO 63025-1109 - Phone
- (636) 938-9310
- NPI assigned
- Nov 1, 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
- Candace M Mangrum
- Title
- Billing
- Phone
- (314) 275-8737
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2005031148 | MO | Primary |
Addresses
Primary practice location
113 W 5TH St
Eureka, MO 63025-1109
Mailing address
1585 Woodlake Dr Ste 214
Chesterfield, MO 63017-5740
Other names 1
- Breakthrough Pain Relief Clinics
National Provider Directory
National Provider DirectoryLocations
1585 Woodlake Dr
Ste 214
Chesterfield, MO 63017
Phone (314) 205-8858
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351728000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1359331200000",
"number": "1821342619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1585 WOODLAKE DR STE 214",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630175740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 W 5TH ST",
"city": "EUREKA",
"state": "MO",
"postal_code": "630251109",
"telephone_number": "636-938-9310"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PAIN RELIEF PARTNERS",
"organizational_subpart": "NO",
"enumeration_date": "2012-11-01",
"last_updated": "2013-01-28",
"status": "A",
"authorized_official_last_name": "MANGRUM",
"authorized_official_first_name": "CANDACE",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "BILLING",
"authorized_official_telephone_number": "314-275-8737"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "MO",
"license": "2005031148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Breakthrough Pain Relief Clinics",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Eureka, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.