Indiana Interventional Pain, LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

INDIANA INTERVENTIONAL PAIN, LLC

Practice address

5445 E 16TH St
Indianapolis, IN 46218-4869

Phone

(317) 355-4358

Fax

(317) 567-2191

NPI assigned

Jun 15, 2006

Organization subpart

No

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

Authorized official

Name

John B Swofford, D.O.

Title

President-Owner

Phone

(317) 567-2180

Specialties & licenses 2

Addresses

Other identifiers 3

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1982648762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3056",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462063056",
            "telephone_number": "317-567-2180",
            "fax_number": "317-567-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 E 16TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462184869",
            "telephone_number": "317-355-4358",
            "fax_number": "317-567-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA INTERVENTIONAL PAIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "SWOFFORD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT-OWNER",
        "authorized_official_telephone_number": "317-567-2180",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IN",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "IN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200530430",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE7729",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000373172",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Indiana Math and Science Academy
• Indiana Math and Science Academy - Central
• Indiana Math and Science Academy North
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• Pain Medicine (Anesthesiology) Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Pain Medicine (Anesthesiology) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.