Active NPI
NRH Pain Management Group LLC
- Ambulatory Surgical Clinic/Center
- Southlake, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- NRH PAIN MANAGEMENT GROUP LLC
- Practice address
- 3075 W Southlake Blvd
Southlake, TX 76092-6730 - Phone
- (817) 310-1065
- NPI assigned
- Feb 24, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Misty Blackwood
- Title
- Authorized Official
- Phone
- (817) 337-3433
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
3075 W Southlake Blvd
Southlake, TX 76092-6730
Mailing address
3075 W Southlake Blvd
Southlake, TX 76092-6730
Phone (817) 310-1065
Other names 1
- Castle Surgery Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231023001612 | TX | Part B Supplier - Ambulatory Surgical Center | 4880040161 | Practice locations: Southlake, TX |
Ambulatory surgical center certification: CCN 45C0451296
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- CASTLE SURGERY CENTER
- Certification status
- Active
- Provider type (POS)
- Ambulatory surgical center
- Participating since
- Aug 9, 2024
- Last certification
- Jul 10, 2024
- Ownership / control type
- Proprietary
- Facility address
- 3075 W Southlake Blvd
Southlake, TX 76092
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2289135 | Castle Surgery Center | Certificate of waiver | Sep 5, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- All-Star Orthopaedics
Other organizations with this tax ID 9
Organizations that report the same tax identification number in the National Provider Directory.
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- NPI 1205586997
-
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- NPI 1871243634
-
- Clinic/Center
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- NPI 1316697048
-
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- NPI 1710637566
-
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- NPI 1013667864
-
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-
- Physical Therapy Clinic/Center
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- NPI 1164172912
-
- Sports Medicine (Orthopaedic Surgery) Physician
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645660800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1724025600000",
"number": "1992451389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3075 W SOUTHLAKE BLVD",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760926730",
"telephone_number": "817-310-1065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3075 W SOUTHLAKE BLVD",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760926730",
"telephone_number": "817-310-1065"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NRH PAIN MANAGEMENT GROUP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-02-24",
"last_updated": "2024-08-19",
"certification_date": "2024-07-23",
"status": "A",
"authorized_official_last_name": "BLACKWOOD",
"authorized_official_first_name": "MISTY",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "817-337-3433"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Castle Surgery Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.