Organization Active NPI

Cumberland Valley Pain Management, PC

  • Interventional Pain Medicine Physician
  • Carlisle, PA
National Provider Identifier
1902007545
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
MD043353L Issued in PA
Legal business name
CUMBERLAND VALLEY PAIN MANAGEMENT, PC
Practice address
5 Tyler CT
Suite B
Carlisle, PA 17013-7671
Phone
(717) 249-9222
Fax
(717) 249-5345
NPI assigned
May 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Authorized official

Name
Dr. Ted Daniel Kosenske, MD
Title
President
Phone
(717) 249-9222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X MD043353L PA Primary

Addresses

Primary practice location

5 Tyler CT
Suite B
Carlisle, PA 17013-7671

Mailing address

5 Tyler CT
Suite B
Carlisle, PA 17013-7671
Phone (717) 249-9222

Other identifiers 1

IdentifierTypeStateIssuer
0012887110006MedicaidPA

National Provider Directory

National Provider Directory

Locations

5 Tyler Ct
Carlisle, PA 17015
Phone (240) 800-5291

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1902007545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 TYLER CT",
            "address_2": "SUITE B",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170137671",
            "telephone_number": "717-249-9222",
            "fax_number": "717-249-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 TYLER CT",
            "address_2": "SUITE B",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170137671",
            "telephone_number": "717-249-9222",
            "fax_number": "717-249-5345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND VALLEY PAIN MANAGEMENT, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "KOSENSKE",
        "authorized_official_first_name": "TED",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-249-9222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "PA",
            "license": "MD043353L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012887110006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlisle, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.