Physician Wellness, LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

0101059231 Issued in VA

Legal business name

PHYSICIAN WELLNESS, LLC

Practice address

825 Davis St
E
Blacksburg, VA 24060-7009

Phone

(540) 953-3300

NPI assigned

Feb 20, 2014

Last updated

Feb 20, 2014By 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

Konrad H Kaeding

Title

Owner

Phone

(302) 593-5904

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392854400000",
    "number": "1821413311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 DAVIS ST",
            "address_2": "E",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607009",
            "telephone_number": "540-953-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 DAVIS ST",
            "address_2": "E",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607009",
            "telephone_number": "540-953-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-20",
        "last_updated": "2014-02-20",
        "status": "A",
        "authorized_official_last_name": "KAEDING",
        "authorized_official_first_name": "KONRAD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-593-5904"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "VA",
            "license": "0101059231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ganesh Phayal, MD
• Michael Phifer
• Phillip Johnson (New River Valley O & P)
• Darian Elizabeth Phillips Fawbush, LPC
• Macaylah Alexis Phillips, PTA
• Physicians Interventional Pain Center LLC
• Carolyn Pickett, PHD
• Lynn Anne B Piechoski, PA
• Emily Margaret Pierson, PHYSICIAN ASSISTANT
• Ellen Piilonen, LPC

• Pain Medicine (Anesthesiology) Physician in Blacksburg, VA
• Providers in Blacksburg, VA by specialty
• Pain Medicine (Anesthesiology) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; 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.