INTERVENTIONAL SPINE AND JOINT SPECIALISTS, LLC


Address: 24 Joliet St, Dyer, IN 46311-1705
Phone: 2198642237

INTERVENTIONAL SPINE AND JOINT SPECIALISTS, LLC (NPI# 1104387521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104387521
Entity Type Organization
Organization Name INTERVENTIONAL SPINE AND JOINT SPECIALISTS, LLC
Practice Address 24 Joliet St
Dyer
IN 46311-1705
Mailing Address Po Box 3039
Munster
IN 46321-0039
Practice Telephone 2198642237
Enumeration Date 2019-03-28
Last Update Date 2020-02-02
Authorized Official Name DR. PRASANTH NUTHAKKI (CEO)
Authorized Official Telephone 2198360296
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 204R00000X Electrodiagnostic Medicine Allopathic & Osteopathic Physicians
N 208100000X Physical Medicine & Rehabilitation Allopathic & Osteopathic Physicians
N 2081S0010X Physical Medicine & Rehabilitation
Specialization: Sports Medicine
Allopathic & Osteopathic Physicians
Y 208VP0014X Pain Medicine
Specialization: Interventional Pain Medicine
Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
759 45th St Ste 201, Munster, IN 463212938 2198360296

Office Location

Street Address 24 JOLIET ST
City DYER
State IN
Zip Code 46311-1705

Providers in the same location

NPI Name Taxonomy Address Enumeration
1972595361 Harvey Joseph Levin Surgery 24 Joliet St, Ste101, Dyer, IN 46311-1705 2005-08-22
1528687274 Joshua Alexander Mclaughlin Student in an Organized Health Care Education/Training Program 24 Joliet St, Dyer, IN 46311-1705 2020-04-13
1225689169 Kayla Marie Ranek Surgery 24 Joliet St, Dyer, IN 46311-1705 2019-09-23
1689221061 Lindsey Marie Kolakoski Registered Nurse 24 Joliet St, Dyer, IN 46311-1705 2019-08-21
1588225320 Mindy Ruan Registered Nurse 24 Joliet St, Dyer, IN 46311-1705 2019-06-24
1568021434 Lindsey Marie Kilsdonk Registered Nurse 24 Joliet St, Dyer, IN 46311-1705 2019-06-13
1457919292 Aja Simone Rivera Registered Nurse 24 Joliet St, Dyer, IN 46311-1705 2019-06-05
1841751526 Artinder Preet Nanrhe Student in an Organized Health Care Education/Training Program 24 Joliet St, Dyer, IN 46311-1705 2019-03-26
1306311865 Joan Levesque Counselor 24 Joliet St, Dyer, IN 46311-1705 2018-10-10
1467959726 Benjamin Allan Webb Student in an Organized Health Care Education/Training Program 24 Joliet St, Dyer, IN 46311-1705 2018-04-12
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1407338858 Leena Yousef-diaz Nurse Practitioner 1100 Joliet Street Suite #201, Dyer, IN 46311 2018-09-02
1518476639 Kor Speech Therapy, LLC Speech-Language Pathologist 219 Primrose Dr., Dyer, IN 46311 2017-09-20
1861921207 Derrick Durrah Counselor 2615 James Drive, Dyer, IN 46311 2017-06-08
1073962189 Maria Lule Pharmacist 805 Joliet Road, Dyer, IN 46311 2016-06-09
1780072157 Mario Munoz Skilled Nursing Facility 515 Audrey Ct, Dyer, IN 46311 2015-01-07
1457772451 Lisa Jennifer Mickelson Registered Nurse 600 Joliet St., Kahler Middle School, Dyer, IN 46311 2013-12-18
1285055285 Tanya D Burk-willson Registered Nurse 14600 W 81st St., Bibich Elementary, Dyer, IN 46311 2013-12-18
1013338011 Mary Beth Rinaldi Registered Nurse 1121 Harrison Ave, Protsman Elementary, Dyer, IN 46311 2013-12-18
1023448057 Franciscan Alliance General Acute Care Hospital 24 Joliet Street, 3da, Dyer, IN 46311 2013-11-12
1508078239 Fatima Jaffer Md Sc PC Internal Medicine Physicians Pavilion Suite 101, 24 East Joliet Street, Dyer, IN 46311 2007-05-04
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Taxonomy Information

Taxonomy Code 208VP0014X
Grouping Allopathic & Osteopathic Physicians
Classification Pain Medicine
Specialization Interventional Pain Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1578176087 Pg Pro LLC Pain Medicine 4715 Statesmen Dr Ste Ab, Indianapolis, IN 46250-5642 2020-08-25
1942818109 Advanced Pain Treatment of Chicago Sc Pain Medicine 1950 45th St Ste 101, Munster, IN 46321-3958 2020-07-14
1871050781 Pain Management Solution LLC Pain Medicine 4010 W Goeller Blvd Ste C, Columbus, IN 47201-8312 2019-02-27
1841764495 Pain Management Centers of America, Psc Pain Medicine 1717 S State Road 57 Ste F, Washington, IN 47501-4179 2019-01-16
1982185641 Midwest Pain Institute Center for Minimally Invasive Spine PC Pain Medicine 7301 N Shadeland Ave Ste 1a, Indianapolis, IN 46250-2085 2018-08-22
1679088405 Advanced Pain Care Clinic Psc Pain Medicine 5320 Weston Rd, Evansville, IN 47712-3701 2017-12-01
1730612698 Advanced Pain Care Clinic Psc Pain Medicine 1813 Willow St Ste 3b, Vincennes, IN 47591 2017-04-07
1366987513 Gary Gettelfinger Md Dabpm LLC Pain Medicine 1619 N Prairie Green Ct, Bloomington, IN 47408-8701 2016-12-27
1053785774 Michael P Royalty Md LLC Pain Medicine 4888 Lost Lake Ct, Boonville, IN 47601 2015-11-18
1801938642 Michael G. Cassaro, Md, Psc Pain Medicine 200 Missouri Ave, Suite B, Jeffersonville, IN 47130-3061 2007-02-12
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Competitor

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City DYER
Zip Code 46311

Improve Information

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Dataset Information

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.

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