NPIMap

Organization Active NPI

Gershon Pain Specialists, LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Virginia Beach, VA
National Provider Identifier
1871710798
Registry record updated Jun 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
0101048068 Issued in VA
Legal business name
GERSHON PAIN SPECIALISTS, LLC
Practice address
1133 First Colonial Rd
Virginia Beach, VA 23454-2402
Phone
(757) 496-2050
Fax
(757) 689-4357
NPI assigned
Apr 20, 2007
Last updated
Jun 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2012

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

Authorized official

Name
Steven L Gershon, M.D.NPI 1073541736
Title
President
Phone
(757) 496-2050

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
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 0101048068 VA Primary

Addresses

Primary practice location

1133 First Colonial Rd
Virginia Beach, VA 23454-2402

Mailing address

1133 First Colonial Rd
Virginia Beach, VA 23454-2402
Phone (757) 496-2050

Other identifiers 3

IdentifierTypeStateIssuer
6668240001OtherMEDICARE NSC
1073541736MedicaidVA
279949OtherVAANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070612000673 VA Part B Supplier - Clinic/Group Practice 7618075821 Receives reassigned benefits from 16 practitioners
Practice locations: Virginia Beach, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340928000000",
    "number": "1871710798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 FIRST COLONIAL RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542402",
            "telephone_number": "757-496-2050",
            "fax_number": "757-689-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 FIRST COLONIAL RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542402",
            "telephone_number": "757-496-2050",
            "fax_number": "757-689-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERSHON PAIN SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2012-06-29",
        "status": "A",
        "authorized_official_last_name": "GERSHON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-496-2050",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "VA",
            "license": "0101048068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC",
            "identifier": "6668240001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073541736",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "279949",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; 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.