PG PRO LLC (NPI# 1578176087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578176087 |
| Entity Type | Organization |
| Organization Name | PG PRO LLC |
| Practice Address |
4715 Statesmen Dr Ste Ab Indianapolis IN 46250-5642 |
| Mailing Address |
Po Box 11180 Tempe AZ 85284-0020 |
| Practice Telephone | 3176435865 |
| Practice Fax Number | 3174367212 |
| Mailing Telephone | 4809304018 |
| Mailing Fax Number | 4809304018 |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2020-11-05 |
| Authorized Official Name | JEREMY BUCKNER (SOLE OWNER) |
| Authorized Official Telephone | 4809304018 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
4715 STATESMEN DR STE AB |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46250-5642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861037004 | Angela L Davis | Pharmacist | 8520 Bash St, Indianapolis, IN 46250 | 2019-11-12 |
| 1710455738 | Physicians Wellness Associates LLC | Family Medicine | 4735 Statesmen Drive, Suite C, Indianapolis, IN 46250 | 2018-11-07 |
| 1891222584 | Confidential Drug LLC | Pharmacy | 8520 Bash St Ste D, Indianapolis, IN 46250 | 2017-05-12 |
| 1659813590 | Occupational Health Centers of The Southwest Pa | Clinic/Center | 8257 Center Run Rd, Indianapolis, IN 46250 | 2016-11-09 |
| 1194275669 | Lucina Treatment Center, LLC | Internal Medicine | 8140 Castleton Rd, Indianapolis, IN 46250 | 2016-10-09 |
| 1609126150 | Joseph Lee Deck | Physical Therapist | 7400 Jewel Lane, Indianapolis, IN 46250 | 2012-09-12 |
| 1447508254 | Choices Coordinated Care Solutions, Inc. | Clinic/Center | 7941 Castleway Drive, Indianapolis, IN 46250 | 2012-08-28 |
| 1568719854 | Lynda L. Blackwelder, LLC | Marriage & Family Therapist | 4735 Statesmen Dr., Suite A, Indianapolis, IN 46250 | 2012-08-06 |
| 1972859452 | Courtney B. Cortez | Nurse Practitioner | 12400 N Meridian Ste 100, Suite 500, Indianapolis, IN 46250 | 2012-08-02 |
| 1861761934 | Kb Medical, Inc. | Durable Medical Equipment & Medical Supplies | 8455, Castlewood Drive, Suite J, Idianapolis, IN 46250 | 2011-12-20 |
| Find all providers in zip 46250 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1174528152 | David M Ratzman | Pain Medicine | 8240 Naad Rd, Ste 101, Indianapolis, IN 46260-1985 | 2005-06-16 |
| 1346360716 | Shadeland Anesthesia & Pain Associates Inc | Pain Medicine | 8805 N Meridian St, Indianapolis, IN 46260-2332 | 2007-03-30 |
| 1396828638 | Alexandru N Nitu | Pain Medicine | 6820 Parkdale Pl, Suite 105, Indianapolis, IN 46254-4699 | 2006-10-23 |
| 1477589000 | Shadeland Anesthesia & Pain Associates Inc. | Pain Medicine | 8805 N Meridian St, Indianapolis, IN 46260-2332 | 2006-06-24 |
| 1497790778 | David M Ratzman, Md, PC | Pain Medicine | 8240 Naab Rd, Suite 101, Indianapolis, IN 46260-5927 | 2006-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 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 |
| 1497841068 | Gavin D Chartier LLC | Pain Medicine | 328 N 2nd St, Suite 308, Vincennes, IN 47591-1351 | 2006-10-04 |
| 1487606489 | Terre Haute Pain Care PC | Pain Medicine | 1183 E Canvasback Dr, Terre Haute, IN 47802-5304 | 2006-05-17 |
| Find all providers with the same taxonomy | ||||
| City | INDIANAPOLIS |
| Zip Code | 46250 |
Please comment or provide details below to improve the information on PG PRO LLC.
| 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.