Pain Care Center LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

PAIN CARE CENTER LLC

Practice address

170 Arrowhead Dr
Suite 2
Evanston, WY 82930-9307

Phone

(307) 212-6270

Fax

(307) 212-6271

NPI assigned

Apr 21, 2017

Organization subpart

Yes

Parent organization

PAIN CARE CENTER LLCAs reported in NPPES

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

Authorized official

Name

Jed Shay, M.D.

Title

Physician

Phone

(307) 212-6270

Specialties & licenses 1

Addresses

Part of

Pain Care Center LLC

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1962937441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 COMMERCIAL WAY STE 20",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829014705",
            "telephone_number": "307-212-6270",
            "fax_number": "307-212-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 ARROWHEAD DR",
            "address_2": "SUITE 2",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829309307",
            "telephone_number": "307-212-6270",
            "fax_number": "307-212-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CARE CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PAIN CARE CENTER LLC",
        "enumeration_date": "2017-04-21",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "SHAY",
        "authorized_official_first_name": "JED",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "307-212-6270",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Anesthesiology) Physician in Evanston, WY
• Providers in Evanston, WY by specialty
• Pain Medicine (Anesthesiology) Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.