Active NPI
Peninsula Pain Clinic, PLLC
- Pain Clinic/Center
- Bremerton, WA
National Provider Identifier
1912376005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Clinic/Center
- Legal business name
- PENINSULA PAIN CLINIC, PLLC
- Practice address
- 2601 Cherry Ave Ste 200
Bremerton, WA 98310-4208 - Phone
- (360) 415-9110
- Fax
- (360) 479-0265
- NPI assigned
- Sep 18, 2015
- Organization subpart
- Yes
- Parent organization
- PENINSULA PAIN CLINIC, PLLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Terry Pexton, DO
- Title
- Medical Director
- Phone
- (360) 415-9110
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Pain Clinic/Center | 261QP3300X | Primary | ||
| Non-Pharmacy Dispensing Site | 332900000X | OP60339103 | WA |
Addresses
Primary practice location
2601 Cherry Ave Ste 200
Bremerton, WA 98310-4208
Mailing address
2980 N Beverly Glen Cir Ste 100
Los Angeles, CA 90077-1728
Phone (310) 943-4180
National Provider Directory
National Provider Directory- Part of
- Peninsula Pain Clinic P
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pain Medicine (Anesthesiology) Physician
- Silverdale, WA
- NPI 1255398178
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442534400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1563753600000",
"number": "1912376005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2980 N BEVERLY GLEN CIR STE 100",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900771728",
"telephone_number": "310-943-4180",
"fax_number": "888-431-8819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 CHERRY AVE STE 200",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983104208",
"telephone_number": "360-415-9110",
"fax_number": "360-479-0265"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PENINSULA PAIN CLINIC, PLLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PENINSULA PAIN CLINIC, PLLC",
"enumeration_date": "2015-09-18",
"last_updated": "2019-07-22",
"status": "A",
"authorized_official_last_name": "PEXTON",
"authorized_official_first_name": "TERRY",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "360-415-9110",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QP3300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Pain",
"state": null,
"license": null,
"primary": true
},
{
"code": "332900000X",
"taxonomy_group": "",
"desc": "Non-Pharmacy Dispensing Site",
"state": "WA",
"license": "OP60339103",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bremerton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.