AVENSTAR PAIN SPECIALISTS, PLLC (NPI# 1104219385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104219385 |
| Entity Type | Organization |
| Organization Name | AVENSTAR PAIN SPECIALISTS, PLLC |
| Other Organization Name | RANDALL PAIN MANAGMENT |
| Practice Address |
5104 S Sooner Rd Oklahoma City OK 73135-5440 |
| Practice Telephone | 4056751993 |
| Practice Fax Number | 4054380487 |
| Mailing Telephone | 4054380913 |
| Mailing Fax Number | 4054380958 |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2019-07-31 |
| Authorized Official Name | KENDRA THOMPSON (ADMINISTRATIVE MANAGER) |
| Authorized Official Telephone | 4054380913 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
N4691 | TX | Allopathic & Osteopathic Physicians |
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
2493 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200341890A | 05 |
| Other Name | Type Code |
|---|---|
| Avenstar Pain Specialists | Doing Business As Name - Organization |
| Randall Pain Managment | Doing Business As Name - Organization |
| Street Address |
5104 S SOONER RD |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73135-5440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902078298 | Steve Eric Randall | Family Medicine | 5104 S Sooner Rd, Oklahoma City, OK 73135-5440 | 2008-03-27 |
| 1346589397 | Daniel Pham Md PC | Family Medicine | 5104 S Sooner Rd, Oklahoma City, OK 73135-5440 | 2013-02-12 |
| 1790030419 | Midwest City Hma Physician Management, LLC | Family Medicine | 5104 S Sooner Rd, Oklahoma City, OK 73135-5440 | 2012-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770182065 | Ifeoluwa Ochuwa Idode | Case Manager/Care Coordinator | 8135 Bigwood Drive, Oklahoma City, OK 73135 | 2020-10-19 |
| 1295359248 | Optimum Complete Care, Pllc | Emergency Medicine | 5200 E. Interstate 240 Service Rd., Oklahoma City, OK 73135 | 2020-06-05 |
| 1649802117 | Everest Rehabilitation Hospital Okc, LLC | Rehabilitation Hospital | 7900 Midamerica Blvd, Oklahoma City, OK 73135 | 2020-02-12 |
| 1225592496 | Crimson Spire Pharmacy | Pharmacy | 5600 S.e. 67 Str, Suite A, Okc, OK 73135 | 2019-01-22 |
| 1285174201 | Yizhen Elizabeth Liu | Student in an Organized Health Care Education/Training Program | 1040, 7050 S Air Depot Blvd, Tinker Afb, OK 73135 | 2017-02-24 |
| 1891149647 | Daniel Enriquez | General Practice | 1040 7050 S Air Depot Blvd, Oklahoma City, OK 73135 | 2016-04-18 |
| 1215302641 | Darryl English II | Case Management | 4328 S.e. 46th Street Apt#160, Oklahoma City, OK 73135 | 2015-12-10 |
| 1063838639 | Charles Lloyd Wilson | Hospitalist | Mercy South, 5200 E I-240 Service Road, Oklahoma City, OK 73135 | 2014-03-06 |
| 1669809877 | Bodyworx Physical Therapy, Pllc | Physical Therapist | 5617 S. E. 67th Street, Oklahoma City, OK 73135 | 2013-10-02 |
| 1578815262 | Kenyatta Lampley | Behavioral Analyst | 5712 Se 86th, Oklahoma City, OK 73135 | 2012-10-05 |
| Find all providers in zip 73135 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568946846 | Medical Center Pain Clinic, LLC | Pain Medicine | 1226 N Shartel Ave Suite 300, Oklahoma City, OK 73103 | 2018-09-21 |
| 1942620604 | Joshua Marvin Woolard | Pain Medicine | 3601 Nw 138th St Ste 200, Oklahoma City, OK 73134-2513 | 2014-04-21 |
| 1497375463 | Clinilogic LLC | Pain Medicine | 3727 Nw 63rd St Ste 302, Oklahoma City, OK 73116-1931 | 2020-04-20 |
| 1245730167 | Interventional Spine Services- II, LLC | Pain Medicine | 1907 N Broadway Ave, Oklahoma City, OK 73103-4407 | 2018-02-16 |
| 1700235645 | Elite Pain & Health PC | Pain Medicine | 13100 N Western Ave Ste 200, Oklahoma City, OK 73114-1431 | 2016-06-10 |
| 1366822298 | Oklahoma Pain Physicians PC | Pain Medicine | 13301 N Meridian Ave, Bldg 600, Oklahoma City, OK 73120-9369 | 2015-06-05 |
| 1518345248 | Oklahoma Spine Hospital LLC | Pain Medicine | 14101 Parkway Commons Dr, Oklahoma City, OK 73134-6012 | 2015-05-14 |
| 1275947335 | Timothy Luke Cramer | Pain Medicine | 1226 N Shartel Ave, Suite 300, Oklahoma City, OK 73103 | 2014-06-17 |
| 1487072385 | Pro Medical Inc | Pain Medicine | 1145 Sw 74th Street, Bldg 1 Suite 300, Oklahoma City, OK 73139-2171 | 2014-03-29 |
| 1568701332 | Jack E. Marshall Md LLC | Pain Medicine | 14100 Parkway Commons Dr, Suite 100, Oklahoma City, OK 73134-6036 | 2013-02-13 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73135 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.