Organization Active NPI

Pain Management Depot Inc

  • Multi-Specialty Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1841810686
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PAIN MANAGEMENT DEPOT INC
Practice address
811 S Decatur Blvd
Las Vegas, NV 89107-3933
Phone
(702) 808-6501
Fax
(702) 685-8450
NPI assigned
Apr 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Authorized official

Name
Dr. Franklin Akioyame, DNP
Title
Owner
Phone
(702) 992-3563

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

811 S Decatur Blvd
Las Vegas, NV 89107-3933

Mailing address

2465 Reynolds Ave Ste 301
N Las Vegas, NV 89030-7296
Phone (702) 992-3563

Other identifiers 1

IdentifierTypeStateIssuer
2600379066OtherNVDRIVERS LICENSE

National Provider Directory

National Provider Directory

Locations

2465 Reynolds Ave
Ste 301
North Las Vegas, NV 89030
Phone (702) 916-0685

NPI Registry JSON

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1841810686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2465 REYNOLDS AVE STE 301",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "890307296",
            "telephone_number": "702-992-3563",
            "fax_number": "725-204-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 S DECATUR BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891073933",
            "telephone_number": "702-808-6501",
            "fax_number": "702-685-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MANAGEMENT DEPOT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-22",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "AKIOYAME",
        "authorized_official_first_name": "FRANKLIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-992-3563",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "2600379066",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.