NPIMap

Organization Active NPI

Columbia Basin Pain Management Institute, PLLC

  • Family Medicine Physician
  • Richland, WA
National Provider Identifier
1992105613
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD 00048680 Issued in WA
Legal business name
COLUMBIA BASIN PAIN MANAGEMENT INSTITUTE, PLLC
Doing business as
Columbia Basin Medical Center
Kennewick Medical Center
Practice address
1305 Fowler St Ste 1B
Richland, WA 99352-4719
Phone
(509) 585-6318
NPI assigned
Aug 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Authorized official

Name
Eric Kurtz, D.C.NPI 1043242647
Title
Registered Agent
Phone
(509) 582-3549

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH 00002564 WA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X MD 00048680 WA Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

1305 Fowler St Ste 1B
Richland, WA 99352-4719

Mailing address

1305 Fowler St Ste 1B
Richland, WA 99352-4719
Phone (509) 585-6318

Other names 2

  • Columbia Basin Medical Center Doing business as
  • Kennewick Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150604001838 WA Part B Supplier - Clinic/Group Practice 2264753037 Receives reassigned benefits from 7 practitioners
Practice locations: Richland, WA

National Provider Directory

National Provider Directory

Locations

1721 W Kennewick Ave
#1B
Kennewick, WA 99336
Phone (509) 585-6318

1721 W Kennewick Ave
Ste 1B
Kennewick, WA 99336
Phone (509) 582-3549

1305 Fowler St
Ste 1B
Richland, WA 99352
Phone (509) 585-6318

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645142400000",
    "number": "1992105613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 FOWLER ST STE 1B",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524719",
            "telephone_number": "509-585-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 FOWLER ST STE 1B",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524719",
            "telephone_number": "509-585-6318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA BASIN PAIN MANAGEMENT INSTITUTE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-29",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A",
        "authorized_official_last_name": "KURTZ",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "509-582-3549",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH 00002564",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD 00048680",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbia Basin Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kennewick Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.