NPIMap

Organization Active NPI

Southwest Pain Management Inc

  • Pain Medicine (Anesthesiology) Physician
  • Rock Springs, WY
National Provider Identifier
1902180532
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
7706A Issued in WY
Legal business name
SOUTHWEST PAIN MANAGEMENT INC
Practice address
1200 College Dr
Rock Springs, WY 82901-5868
Phone
(307) 325-8329
NPI assigned
Sep 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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

Authorized official

Name
Dr. Brandon Vashon Mack, MD
Title
President
Phone
(307) 362-1444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X 7706A WY Primary

Addresses

Primary practice location

1200 College Dr
Rock Springs, WY 82901-5868

Mailing address

PO Box 3228
Rock Springs, WY 82902-3228
Phone (307) 362-1444

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1317340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317340800000",
    "number": "1902180532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3228",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829023228",
            "telephone_number": "307-362-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 COLLEGE DR",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829015868",
            "telephone_number": "307-325-8329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST PAIN MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-30",
        "last_updated": "2011-09-30",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "VASHON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "307-362-1444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WY",
            "license": "7706A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Springs, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.