INTERVENTIONAL PAIN & SPINE SPECIALISTS , LLC (NPI# 1790384071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790384071 |
| Entity Type | Organization |
| Organization Name | INTERVENTIONAL PAIN & SPINE SPECIALISTS , LLC |
| Practice Address |
4205 Springhurst Blvd Ste 101 Louisville KY 40241-6159 |
| Mailing Address |
7145 E Virginia St Ste 2000 Evansville IN 47715-9147 |
| Practice Telephone | 5023522530 |
| Mailing Telephone | 8129627894 |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2020-10-19 |
| Authorized Official Name | TAMIA FISHER (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 8129627894 |
| Is Organization Subpart | Y |
| Parent Organization Name | INTERVENTIONAL PAIN & SPINE SPECIALISTS, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | CLIA | 18D2146585 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184110231 | Interventional Pain & Spine Specialists, LLC | Durable Medical Equipment & Medical Supplies | 2700 Old Rosebud Rd Ste 350, Lexington, KY 40509-8630 | 2018-07-02 |
| 1295370419 | Interventional Pain & Spine Specialists, LLC | Durable Medical Equipment & Medical Supplies | 2700 Old Rosebud Rd Ste 350, Lexington, KY 40509-8630 | 2019-11-12 |
| Street Address |
4205 SPRINGHURST BLVD STE 101 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40241-6159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811378524 | East Louisville Interventional Pain Specialists Pllc | Pharmacy | 4205 Springhurst Blvd Ste 101, Louisville, KY 40241-6159 | 2015-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164033353 | Tyler Roberts | Physician Assistant | Private, Louisville, KY 40241 | 2020-08-12 |
| 1639636988 | Paladina Health, LLC | Family Medicine | Paladina Health Louisville Park Plaza, 9720 Park Plaza Avenue #101, Louisville, KY 40241 | 2019-02-22 |
| 1164990396 | Tiffany Elizabeth Gallucci | Nurse Practitioner | 4915 Norton Healthcare Boulevard, Louisville, KS 40241 | 2018-11-06 |
| 1952876146 | Ashley Lynne Johnson Belcher | Psychologist | 9700 Park Plaza Avenue, Ste. 106, Louisville, KY 40241 | 2018-10-04 |
| 1265935977 | Family Podiatry Center Pllc | Podiatrist | 9850 Von Allmen Ct, Louisville, KY 40241 | 2018-03-09 |
| 1346767472 | Bridgett Lin Youngblood | Case Manager/Care Coordinator | 4313 Brownsboro Glen Rd, Louisville, KY 40241 | 2017-08-29 |
| 1518375690 | Amir Shahla | Dentist | 10500 Fischer Park Dr, Louisville, KY 40241 | 2014-08-01 |
| 1255741781 | Alicia M Durham | Marriage & Family Therapist | 3900 Riveroaks Ln, Louisville, KY 40241 | 2014-05-06 |
| 1962826719 | Applied Behavioral Consulting, LLC | Community/Behavioral Health | 4517 Shenandoah Drive, Louisville, KY 40241 | 2014-02-14 |
| 1336579176 | Nicholas Weickel | Physical Therapist | 9880 Angie's Way, Suite 100, Louisville, KY 40241 | 2013-11-14 |
| Find all providers in zip 40241 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528533031 | Katherine Berning | Nurse Anesthetist, Certified Registered | 3022 Eagle Pass, Louisville, KY 40217-1727 | 2018-10-11 |
| 1326559733 | Morgan Ann Baumgartle | Nurse Anesthetist, Certified Registered | Norton Children's Hospital 231 E. Chestnut St, Louisville, KY 40202 | 2017-10-12 |
| 1225385909 | Exacta Anesthesia Pllc | Nurse Anesthetist, Certified Registered | 8809 Linn Station Rd, Louisville, KY 40222-5658 | 2012-08-13 |
| 1740543990 | Tiva Oba, L.L.C. | Nurse Anesthetist, Certified Registered | 4729 Razor Creek Way, Louisville, KY 40299-5533 | 2012-06-22 |
| 1124338579 | Kenneth Eugene Doyon | Nurse Anesthetist, Certified Registered | 601 S Floyd St Ste 407, Louisville, KY 40202-1837 | 2010-10-19 |
| 1508176058 | Jaclyn M Johanboeke | Nurse Anesthetist, Certified Registered | 10207 Springhurst Gardens Cir, Louisville, KY 40241-5194 | 2010-10-18 |
| 1487889143 | Sleep Ez Anesthesia Pllc | Nurse Anesthetist, Certified Registered | 10301 Champion Farms Dr, Louisville, KY 40241-6129 | 2009-05-26 |
| 1700062726 | Jake Chris Chang | Nurse Anesthetist, Certified Registered | 530 S Jackson St Rm C2a03, Louisville, KY 40202-1675 | 2008-01-22 |
| 1205984366 | Stanley Ansel Kristiansen | Nurse Anesthetist, Certified Registered | 1702 Trevilian Way, Louisville, KY 40205-2057 | 2007-01-08 |
| 1841358355 | Michael Dewayne Hart | Nurse Anesthetist, Certified Registered | 16604 Chestnut Glen Pl, Louisville, KY 40245-6121 | 2006-12-05 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40241 |
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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.