Organization Active NPI

Agape Pain Management and Anesthesia, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Las Cruces, NM
National Provider Identifier
1891076519
Registry record updated Dec 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
MD2010-0116 Issued in NM
Legal business name
AGAPE PAIN MANAGEMENT AND ANESTHESIA, LLC
Practice address
2170 E Lohman Ave
Suite C
Las Cruces, NM 88001-8411
Phone
(575) 449-7002
Fax
(575) 652-4684
NPI assigned
Sep 8, 2011
Last updated
Dec 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2014

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

Authorized official

Name
Dr. Llewelyn WilliamsNPI 1316922750
Title
MD/Owner
Phone
(575) 449-7002

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) Physician 207LP2900X MD2010-0116 NM Primary

Addresses

Primary practice location

2170 E Lohman Ave
Suite C
Las Cruces, NM 88001-8411

Mailing address

2170 E Lohman Ave
Suite C
Las Cruces, NM 88001-8411
Phone (575) 449-7002

Other identifiers 1

IdentifierTypeStateIssuer
25575244MedicaidNM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120224000758 NM Part B Supplier - Clinic/Group Practice 9931367745 Receives reassigned benefits from 5 practitioners
Practice locations: Las Cruces, NM

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
32D2095249Agape Pain Management & Anesthesia LLC2170 E Lohman Ave Ste C, Las Cruces, NM 88001ComplianceDec 8, 2027

National Provider Directory

National Provider Directory

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": "1315440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417564800000",
    "number": "1891076519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2170 E LOHMAN AVE",
            "address_2": "SUITE C",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880018411",
            "telephone_number": "575-449-7002",
            "fax_number": "575-652-4684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 E LOHMAN AVE",
            "address_2": "SUITE C",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880018411",
            "telephone_number": "575-449-7002",
            "fax_number": "575-652-4684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE PAIN MANAGEMENT AND ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-08",
        "last_updated": "2014-12-03",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LLEWELYN",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "575-449-7002",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NM",
            "license": "MD2010-0116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25575244",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; 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.