Peninsula Pain Management, LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

D0035246 Issued in MD

Legal business name

PENINSULA PAIN MANAGEMENT, LLC

Practice address

13014 Riggin Ridge Rd
Ocean City, MD 21842-9716

Phone

(443) 783-3543

NPI assigned

Jun 8, 2009

Organization subpart

No

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

Authorized official

Name

Brent Fox

Title

Owner

Phone

(443) 783-3543

Specialties & licenses 5

Addresses

Other names 1

• Fox Laser, LLC Former legal business name

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354924800000",
    "number": "1861628521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13014 RIGGIN RIDGE RD",
            "city": "OCEAN CITY",
            "state": "MD",
            "postal_code": "218429716",
            "telephone_number": "443-783-3543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13014 RIGGIN RIDGE RD",
            "city": "OCEAN CITY",
            "state": "MD",
            "postal_code": "218429716",
            "telephone_number": "443-783-3543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA PAIN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-08",
        "last_updated": "2012-12-08",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-783-3543"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MD",
            "license": "D0035246",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MD",
            "license": "D0035246",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fox Laser, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Ocean City Family Practice & Urgent Care PC
• Ocean City Family Practice &Urgent Care, P.C.
• Ocean City Primary Care
• Ocean Wellness (Lisa Thommen)
• Caleb Wesley Page Jr., MD
• Peninsula Rehab & Sports Medicine, Inc.
• Peninsula Rehabilitation & Sports Medicine, Inc. (Peninsula Rehab & Sports Medicine, Inc.)
• Thomas T Penroach, M.D.
• Lisa Ann Peppers, PSY.D.
• Maia Perone, CNS

• Interventional Pain Medicine Physician in Ocean City, MD
• Providers in Ocean City, MD by specialty
• Interventional Pain Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2012; 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.