Organization Active NPI

Advanced Pain Management of Elwood

  • Multi-Specialty Clinic/Center
  • Elwood, IN
National Provider Identifier
1982240917
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ADVANCED PAIN MANAGEMENT OF ELWOOD
Practice address
7408 W State Road 28
Elwood, IN 46036-8600
Phone
(765) 557-8569
Fax
(765) 557-8635
NPI assigned
Nov 25, 2019
Last updated
Jul 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Authorized official

Name
David Dunham, NP, DPT, DCNPI 1184719338
Title
Owner
Phone
(765) 557-8569

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Multi-Specialty Clinic/Center 261QM1300X Primary
Clinical Medical Laboratory 291U00000X
Durable Medical Equipment & Medical Supplies 332B00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

7408 W State Road 28
Elwood, IN 46036-8600

Mailing address

7408 W State Road 28
Elwood, IN 46036-8600
Phone (765) 557-8569

Other practice location 1

2976 N Scatterfield Rd Ste 111
Anderson, IN 46012-1586
Phone (765) 557-8569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200225001418 IN Part B Supplier - Clinic/Group Practice 2062849474 Receives reassigned benefits from 6 practitioners
Practice locations: Anderson, IN; Westfield, IN

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2055704Advanced Pain Management of Elwood2976 N Scatterfield Rd Suite 111, Anderson, IN 46012ComplianceMar 21, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657584000000",
    "number": "1982240917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7408 W STATE ROAD 28",
            "city": "ELWOOD",
            "state": "IN",
            "postal_code": "460368600",
            "telephone_number": "765-557-8569",
            "fax_number": "765-557-8635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7408 W STATE ROAD 28",
            "city": "ELWOOD",
            "state": "IN",
            "postal_code": "460368600",
            "telephone_number": "765-557-8569",
            "fax_number": "765-557-8635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2976 N Scatterfield Rd Ste 111",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "IN",
            "postal_code": "460121586",
            "country_code": "US",
            "telephone_number": "765-557-8569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED PAIN MANAGEMENT OF ELWOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-25",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A",
        "authorized_official_last_name": "DUNHAM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-557-8569",
        "authorized_official_credential": "NP, DPT, DC"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.