NPIMap

Organization Active NPI

Three Rivers Spine & Pain Medicine

  • Interventional Pain Medicine Physician
  • Weirton, WV
National Provider Identifier
1831529379
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
MD425965 Issued in PA
Legal business name
THREE RIVERS SPINE & PAIN MEDICINE
Practice address
249 Three Springs Dr
Weirton, WV 26062-3814
Phone
(304) 919-2077
Fax
(304) 914-4374
NPI assigned
Nov 20, 2013
Last updated
Jul 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Authorized official

Name
Mrs. Stephanie Le, MDNPI 1326023888
Title
President
Phone
(304) 919-2077

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X MD425965 PA Primary

Addresses

Primary practice location

249 Three Springs Dr
Weirton, WV 26062-3814

Mailing address

PO Box 791
Carnegie, PA 15106-0791
Phone (412) 655-4362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140305000523 PA Part B Supplier - Clinic/Group Practice 7214167634 Receives reassigned benefits from 1 practitioner
Practice locations: Pittsburgh, PA
O20160725002652 WV Part B Supplier - Clinic/Group Practice 7214167634 Receives reassigned benefits from 1 practitioner
Practice locations: Weirton, WV

National Provider Directory

National Provider Directory

Locations

249 Three Springs Dr
Weirton, WV 26062
Phone (304) 919-2077

310 American Way
#B
Weirton, WV 26062
Phone (412) 490-0400

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1384905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1831529379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791",
            "city": "CARNEGIE",
            "state": "PA",
            "postal_code": "151060791",
            "telephone_number": "412-655-4362",
            "fax_number": "412-653-7684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 THREE SPRINGS DR",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260623814",
            "telephone_number": "304-919-2077",
            "fax_number": "304-914-4374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS SPINE & PAIN MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-20",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-919-2077",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "PA",
            "license": "MD425965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weirton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.