COMPREHENSIVE PAIN REHAB OF SOUTHERN INDIANA LLC (NPI# 1578870879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578870879 |
| Entity Type | Organization |
| Organization Name | COMPREHENSIVE PAIN REHAB OF SOUTHERN INDIANA LLC |
| Other Organization Name | PAIN MANAGEMENT SURGERY CENTER |
| Practice Address |
2920 Mcintire Drive Suite 150b Bloomington IN 47403-4213 |
| Practice Telephone | 8123337246 |
| Practice Fax Number | 8123334471 |
| Mailing Telephone | 8123337246 |
| Mailing Fax Number | 8123334471 |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2010-09-08 |
| Authorized Official Name | DERK FRASIER (OWNER) |
| Authorized Official Telephone | 8123337246 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | IN | Allopathic & Osteopathic Physicians | |
| N | 363L00000X | Nurse Practitioner | IN | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
IN | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
IN | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Pain Management Surgery Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689981979 | Comprehensive Pain Rehab of Southern Indiana LLC | Anesthesiology | 8802 S. Madison Avenue, Suite D, Indianapolis, IN 46227-6400 | 2010-09-08 |
| 1245546506 | Comprehensive Pain Rehab of Southern Indiana LLC | Nurse Practitioner | 2920 Mcintire Drive, Suite 150a, Bloomington, IN 47403-4213 | 2010-08-25 |
| Street Address |
2920 MCINTIRE DRIVE SUITE 150B |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47403-4213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962688895 | Brian William Cook | Obstetrics & Gynecology | 2920 Mcintire Drive, Suite 250, Bloomington, IN 47403 | 2008-01-10 |
| 1245546506 | Comprehensive Pain Rehab of Southern Indiana LLC | Nurse Practitioner | 2920 Mcintire Drive, Suite 150a, Bloomington, IN 47403-4213 | 2010-08-25 |
| 1700828845 | Leroy Jackson | Nurse Anesthetist, Certified Registered | 2920 Mcintire Drive, Suite 150, Bloomington, IN 47403 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043783673 | Brook Whitaker | Registered Nurse | 4011 S. Monroe Medical Park Blvd, Bloomington, IN 47403 | 2019-01-07 |
| 1598251175 | Jacob Edward Lundorf | Nurse Practitioner | 2100 S Liberty Dr Ste B, Bloomington, IN 47403 | 2018-07-06 |
| 1568973717 | Gregory Thomas Dougan | Physician Assistant | 418 South Landmark Avenue, Bloomington, IN 47403 | 2017-10-16 |
| 1295276160 | Indiana Center for Recovery, LLC | Substance Abuse Rehabilitation Facility | 1004 W 1st Street, Bloomington, IN 47403 | 2017-03-13 |
| 1144694217 | Kayla Dewolf | Specialist/Technologist | 1471 W Allen St, Bloomington, IN 47403 | 2015-11-30 |
| 1164806444 | Monroe Hosoital | General Acute Care Hospital | 4011 Monroe Medical Park, Bloomington, IN 47403 | 2015-07-16 |
| 1821411588 | Jennifer Turner | Occupational Therapy Assistant | 1023 West Main St, Swiss Villa, Vevay, IN 47403 | 2014-01-30 |
| 1104170232 | Kendall Basore | Social Worker | 445 S. Landmark Ave., Bloomington, IN 47403 | 2012-10-26 |
| 1568715886 | Indiana Hearing LLC | Hearing Aid Equipment | 2019 S Liberty Dr, Bloomington, IN 47403 | 2012-10-24 |
| 1679870232 | Accurate Hearing Services | Clinic/Center | 1355 W Second St, #3, Bloomington, IN 47403 | 2011-02-17 |
| Find all providers in zip 47403 | ||||
| Taxonomy Code | 208VP0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Pain Medicine |
| Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient’s pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies. |
| Notes: Source: American Academy of Pain Medicine, www.painmed.org - Additional Resources:The American Board of Pain Medicine provides Board Certification. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609258763 | Philip Michael Shumsky | Pain Medicine | 1120 West Michigan Street, Cl 626, Indianapolis, IN 46202 | 2015-06-25 |
| 1033501937 | Todd Noel Wolford | Pain Medicine | 10176 W 400 N Ste B, Michigan City, IN 46360-9009 | 2015-03-02 |
| 1376809566 | Xiaogang Jiang | Pain Medicine | 207 Sparks Ave Ste 300, Jeffersonville, IN 47130-3739 | 2012-04-02 |
| 1992981997 | Sonovu Diagnostics LLC | Pain Medicine | 17039 Mercantile Blvd, Noblesville, IN 46060-3941 | 2008-01-21 |
| 1104932185 | Institute of Comprehensive Pain Management, LLC | Pain Medicine | 30 South Emerson Avenue, Greenwood, IN 46143 | 2006-08-22 |
| 1801902192 | Harrison County Hospital | Pain Medicine | 1263 Hospital Dr, Suite 270, Corydon, IN 47112-1878 | 2006-08-21 |
| 1104878982 | Gregory Scott Masimore | Pain Medicine | 730 Executive Park Dr Ste A, Greenwood, IN 46143-3213 | 2006-05-17 |
| 1407825813 | Ryan D Loyd | Pain Medicine | 415 N 26th St., Suite 202, Lafayette, IN 47904 | 2006-03-16 |
| 1700433588 | Deaconess Hospital, Inc | Pain Medicine | 1808 Sherman Dr, Princeton, IN 47670-1043 | 2019-08-26 |
| 1265996144 | Neurology and Pain Medical Associates LLC | Pain Medicine | 123 S Mckinley Ave, Rensselaer, IN 47978-2949 | 2019-01-25 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMINGTON |
| Zip Code | 47403 |
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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.