Organization Active NPI

Institute of Pain Management, P.C.

  • Pain Medicine (Anesthesiology) Physician
  • Oklahoma City, OK
National Provider Identifier
1871772004
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
3429 Issued in OK
Legal business name
INSTITUTE OF PAIN MANAGEMENT, P.C.
Practice address
3328 N Classen Blvd
Oklahoma City, OK 73118-3428
Phone
(405) 524-5200
NPI assigned
Oct 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

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

Authorized official

Name
Liem Trang, D.O.NPI 1619084738
Title
C.E.O. / President
Phone
(405) 524-5200

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 (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X 3429 OK Primary

Addresses

Primary practice location

3328 N Classen Blvd
Oklahoma City, OK 73118-3428

Mailing address

3328 N Classen Blvd
Oklahoma City, OK 73118-3428
Phone (405) 524-5200

Other identifiers 1

IdentifierTypeStateIssuer
100125970BMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140709000431 OK Part B Supplier - Clinic/Group Practice 7517182470 Receives reassigned benefits from 1 practitioner
4 other NPIs on this enrollment
Practice locations: Mangum, OK; Pauls Valley, OK; Oklahoma City, OK; El Reno, OK; Edmond, OK; Chickasha, OK; Ardmore, OK; Anadarko, OK

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D0974990Institute of Pain Management PC3328 N Classen Blvd, Oklahoma City, OK 73118Certificate of waiverJun 21, 2028

National Provider Directory

National Provider Directory

Locations

3328 N Classen Blvd
Oklahoma City, OK 73118
Phone (405) 524-5200

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292198400000",
    "number": "1871772004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3328 N CLASSEN BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731183428",
            "telephone_number": "405-524-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3328 N CLASSEN BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731183428",
            "telephone_number": "405-524-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE OF PAIN MANAGEMENT, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2010-12-13",
        "status": "A",
        "authorized_official_last_name": "TRANG",
        "authorized_official_first_name": "LIEM",
        "authorized_official_title_or_position": "C.E.O. / PRESIDENT",
        "authorized_official_telephone_number": "405-524-5200",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OK",
            "license": "3429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100125970B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.