NPIMap

Organization Active NPI

Interventions in Pain Management LLC

  • Pain Clinic/Center
  • Davenport, IA
National Provider Identifier
1891247904
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
INTERVENTIONS IN PAIN MANAGEMENT LLC
Practice address
3509 Spring St Ste 3
Davenport, IA 52807-2124
Phone
(309) 428-7055
NPI assigned
Oct 25, 2016
Last updated
Apr 3, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
INTERVENTIONS IN PAIN MANAGEMENT LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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

Authorized official

Name
Kerry Panozzo, M.D.NPI 1225017957
Title
Owner
Phone
(309) 721-3288

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 Clinic/Center 261QP3300X NU Primary

Addresses

Primary practice location

3509 Spring St Ste 3
Davenport, IA 52807-2124

Mailing address

4110 Blackhawk Rd Ste 2
Rock Island, IL 61201-7039

National Provider Directory

National Provider Directory
Tax ID family
Kerry Panozzo MD PC5 organizations share this tax ID, including this one
Part of
Kerry Panozzo MD PC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491177600000",
    "number": "1891247904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 BLACKHAWK RD STE 2",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 SPRING ST STE 3",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072124",
            "telephone_number": "309-428-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONS IN PAIN MANAGEMENT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTERVENTIONS IN PAIN MANAGEMENT LLC",
        "enumeration_date": "2016-10-25",
        "last_updated": "2017-04-03",
        "status": "A",
        "authorized_official_last_name": "PANOZZO",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-721-3288",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; 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.