Coastal Interventional Pain Management LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

COASTAL INTERVENTIONAL PAIN MANAGEMENT LLC

Practice address

1099 5TH Ave N
Ste 320
St Petersburg, FL 33705-1469

Phone

(727) 822-7000

Fax

(727) 822-7001

NPI assigned

Nov 2, 2009

Organization subpart

No

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

Authorized official

Name

Jennifer M Burns, MD

Title

Owner

Phone

(727) 822-7000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299110400000",
    "number": "1962738567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 5TH AVE N",
            "address_2": "STE 320",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051469",
            "telephone_number": "727-822-7000",
            "fax_number": "727-822-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 5TH AVE N",
            "address_2": "STE 320",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051469",
            "telephone_number": "727-822-7000",
            "fax_number": "727-822-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL INTERVENTIONAL PAIN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-02",
        "last_updated": "2011-03-03",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-822-7000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS FLORIDA",
            "identifier": "34087",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pain Clinic/Center in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Pain Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.