Paul Brian Juergens, M.D.

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

036067084 Issued in IL

Practice address

900 N Washington St
Du Quoin, IL 62832-1233

Phone

(573) 575-6440

Fax

(618) 942-7399

NPI assigned

Jul 18, 2006

Last updated

Jan 19, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: paul.juergens@mbhdq.medalliesdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrative Spine Care, LLC

  • Pain Medicine Physician
  • Carbondale, IL
  • NPI 1447625918
  Authorized official Same address or phone
• Southern Illinois Pain Management

  • Specialist
  • Marion, IL
  • NPI 1942227863
  NPD (past) Authorized official
• Advanced Spine & Joint

  • Family Nurse Practitioner
  • Paducah, KY
  • NPI 1447484118
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1922026673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3441",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023441",
            "telephone_number": "573-575-6440",
            "fax_number": "618-942-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N WASHINGTON ST",
            "city": "DU QUOIN",
            "state": "IL",
            "postal_code": "628321233",
            "telephone_number": "573-575-6440",
            "fax_number": "618-942-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUERGENS",
        "first_name": "PAUL",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "IL",
            "license": "036067084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamestown Manor Inc (Fairview Nursing and Rehabilitation Center Inc)
• Jamestown Manor Inc (Fairview Nursing & Rehabilitation Center Inc)
• Roger C. Jenkins, OD
• John W. Melvin DC LTD
• Chad R. Johnston, MD
• Beth Keith-Mudgette, RPH
• Kidney Care Services of Southern Illinois, LTD
• Kims Family Healthcare LLC
• Danielle Klump, APRN
• Alisha Kosma

• Pain Medicine Physician in Du Quoin, IL
• Providers in Du Quoin, IL by specialty
• Pain Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; 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.