Lafayette Pain Care PC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LAFAYETTE PAIN CARE PC

Practice address

613 Terrace Dr
Winamac, IN 46996-1111

Phone

(574) 946-4290

Fax

(574) 946-6678

NPI assigned

May 19, 2017

Last updated

Jun 8, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shazia M Siddiqui, MDNPI 1629001680

Title

Owner

Phone

(765) 714-4344

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shazia Meraj Siddiqui, MD

  • Pain Medicine (Anesthesiology) Physician
  • Lafayette, IN
  • NPI 1629001680
  Authorized official Same address or phone

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

{
    "created_epoch": "1495152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496880000000",
    "number": "1972030062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 PARK EAST BLVD",
            "address_2": "SUITE B",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479050786",
            "telephone_number": "765-714-4344",
            "fax_number": "765-838-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 TERRACE DR",
            "city": "WINAMAC",
            "state": "IN",
            "postal_code": "469961111",
            "telephone_number": "574-946-4290",
            "fax_number": "574-946-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFAYETTE PAIN CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-19",
        "last_updated": "2017-06-08",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "SHAZIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-714-4344",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Kletz
• Christine M Knapp, LCSW
• Knox-Winamac Community Health Centers, Inc.
• Nathan R Kreamer
• Kristina Kriskovsky, BS
• Randy C Lehman, MD
• Pamela Jean McKinney, LCSW LMFT
• Michael W Wilson (Alliance EMS)
• Jerra Pauline Moreland, BA
• Kenneth Rebel Noble, RN, DTS

• Durable Medical Equipment & Medical Supplies in Winamac, IN
• Providers in Winamac, IN by specialty
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2017; 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.