Pain Management 360 LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

PAIN MANAGEMENT 360 LLC

Practice address

551 21St St
Huntington, WV 25703-1540

Phone

(917) 935-7788

Fax

(304) 577-8615

NPI assigned

Aug 24, 2022

Organization subpart

No

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

Authorized official

Name

Rudy Malayil, MDNPI 1114151347

Title

Owner

Phone

(917) 645-2591

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WV, OH2 enrollments

Enrollment records 2

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rudy Mathew Malayil, M.D.

  • Interventional Pain Medicine Physician
  • Huntington, WV
  • NPI 1114151347

  OH

  Medicare reassignment Care Compare group NPD Authorized official
• Patricia Annette Stiltner, FNP-BC

  • Family Nurse Practitioner
  • Barboursville, WV
  • NPI 1184975138
  Medicare reassignment Care Compare group NPD
• Kimberly Leanne Thomas, APRN

  • Family Nurse Practitioner
  • Huntington, WV
  • NPI 1730924499
  Medicare reassignment Care Compare group NPD
• Timothy L Morgan, DO

  • Anesthesiology Physician
  • Versailles, KY
  • NPI 1407315732

  WV

  Medicare reassignment Care Compare group NPD
• Maegen Brennan, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Huntington, WV
  • NPI 1255881165
  Medicare reassignment NPD
• Ashley Nicole Cumberledge, PA-C

  • Physician Assistant
  • South Charleston, WV
  • NPI 1164238077
  Medicare reassignment NPD
• Vivekanand S Neginhal, M.D.

  • Orthopaedic Surgery Physician
  • Glasgow, KY
  • NPI 1578635074

  OH, WV

  Medicare reassignment NPD
• Rolando Garcia, PA-C

  • Physician Assistant
  • Washington, PA
  • NPI 1326148115

  WV

  Medicare reassignment

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714089600000",
    "number": "1821717711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33821",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049150616",
            "telephone_number": "888-488-8289",
            "fax_number": "304-577-8615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 21ST ST",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257031540",
            "telephone_number": "917-935-7788",
            "fax_number": "304-577-8615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MANAGEMENT 360 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-24",
        "last_updated": "2024-04-26",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "MALAYIL",
        "authorized_official_first_name": "RUDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-645-2591",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000210",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100858920",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100858910",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821717711",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew R Pack
• Destiny Padgett
• Kennishewa Lewis Page
• Samantha Page
• Pain Care, PLLC
• Mark Painter II, PHARMD
• Reid Allen Painter
• Fnu Pallavi
• Palms Resource Center
• Lauren Panell

• Interventional Pain Medicine Physician in Huntington, WV
• Providers in Huntington, WV by specialty
• Interventional Pain Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.