Pain Medicine Physicians of Jacksonville, LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

ME87424 Issued in FL

Legal business name

PAIN MEDICINE PHYSICIANS OF JACKSONVILLE, LLC

Practice address

10250 Normandy Boulevard
Suite 702
Jacksonville, FL 32221

Phone

(904) 495-7200

Fax

(904) 495-7199

NPI assigned

Oct 7, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Parveen Khanna, MDNPI 1558346106

Title

Medical Director

Phone

(904) 495-7200

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Parveen Khanna, MD

  • Pain Medicine (Anesthesiology) Physician
  • Jacksonville, FL
  • NPI 1558346106
  Medicare reassignment NPD Authorized official
• Mary Kathryn Wright, A.P.R.N

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1104375377
  Medicare reassignment NPD
• Stacy Cameron Perez, APRN FNP-BC

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1952021206
  NPD

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485475200000",
    "number": "1942603899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10250 NORMANDY BLVD",
            "address_2": "SUITE 703",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322218059",
            "telephone_number": "904-495-7200",
            "fax_number": "904-495-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10250 NORMANDY BOULEVARD",
            "address_2": "SUITE 702",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32221",
            "telephone_number": "904-495-7200",
            "fax_number": "904-495-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MEDICINE PHYSICIANS OF JACKSONVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-07",
        "last_updated": "2017-01-27",
        "status": "A",
        "authorized_official_last_name": "KHANNA",
        "authorized_official_first_name": "PARVEEN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "904-495-7200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME87424",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "ME87424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "007Z4",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "DV2304",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sher-Lu Pai, MD
• Carolyn Paige
• Patricia Paige
• Alexa Dyan Paik, APRN
• Pain Care & Physical Therapy, Inc.
• Pain Relief and Rehab Physicians Group Inc
• Pain Relief Institute Inc
• Pain Relief Institute LLC
• Pain Spine & Wellness LLC
• Soe Paing, MD

• Pain Medicine (Anesthesiology) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pain Medicine (Anesthesiology) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.