JERSEYVILLE PAIN MANAGEMENT CENTER, S.C. (NPI# 1811262728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811262728 |
| Entity Type | Organization |
| Organization Name | JERSEYVILLE PAIN MANAGEMENT CENTER, S.C. |
| Practice Address |
1702 Vaughn Rd Wood River IL 62095-1898 |
| Mailing Address |
Po Box 649 Wood River IL 62095-0649 |
| Practice Telephone | 6182593321 |
| Mailing Telephone | 6182593321 |
| Enumeration Date | 2012-03-12 |
| Last Update Date | 2012-03-12 |
| Authorized Official Name | DR. JAMES A BRIGGS (PRESIDENT) |
| Authorized Official Telephone | 6182593321 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 038009545 | IL | Chiropractic Providers |
| N | 111N00000X | Chiropractor | 038004303 | IL | Chiropractic Providers |
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
36048379 | IL | Allopathic & Osteopathic Physicians |
| N | 225100000X | Physical Therapist | 70004750 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
36048379 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 038009545 | 05 | |
| IL | BCBS ILLINOIS | 04232007 | 01 |
| GHP | 224252 | 01 | |
| IL | MEDICARE P-TAN | 5933000001 | 01 |
| IL | MEDICARE ILLINOIS | 210609 | 01 |
| IL | HEALTHLINK | 477779 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063470524 | Jerseyville Pain Management Center, S.c. | Chiropractor | 1702 Vaughn Rd, Wood River, IL 62095 | 2006-05-03 |
| 1255609574 | Jerseyville Pain Management Center, S.c. | Non-Pharmacy Dispensing Site | 1702 Vaughn Rd, Wood River, IL 62095-1898 | 2011-12-01 |
| Street Address |
1702 VAUGHN RD |
| City | WOOD RIVER |
| State | IL |
| Zip Code | 62095-1898 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063470524 | Jerseyville Pain Management Center, S.c. | Chiropractor | 1702 Vaughn Rd, Wood River, IL 62095 | 2006-05-03 |
| 1255609574 | Jerseyville Pain Management Center, S.c. | Non-Pharmacy Dispensing Site | 1702 Vaughn Rd, Wood River, IL 62095-1898 | 2011-12-01 |
| 1871898213 | Aaron Justin Mitchell | Chiropractor | 1702 Vaughn Rd, Suite 4, Wood River, IL 62095-1898 | 2011-01-16 |
| 1871897207 | Erin L Micenheimer | Physician Assistant | 1702 Vaughn Rd, Wood River, IL 62095-1898 | 2010-12-28 |
| 1275697229 | Bud Polpat Chomhirun | Physical Medicine & Rehabilitation | 1702 Vaughn Rd, Suite 1, Wood River, IL 62095-1898 | 2006-12-21 |
| 1831131101 | Wak S Chia | Pediatrics | 1702 Vaughn Rd, Wood River, IL 62095-1898 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467698068 | Jkh Management, LLC | Clinic/Center | 1138 Vaughn Road, Wood River, IL 62095 | 2009-01-02 |
| 1972762367 | Ronald Weems Jr P.C. | Dentist | 1915 Vaughn Road, Wood River, IL 62095 | 2008-06-02 |
| 1306010913 | Kristin Nicole Kellim | Specialist | 1138 Vaughn Rd, Wood River, IL 62095 | 2008-04-15 |
| 1124240569 | Denise Marie Jacquin | Optometrist | 650 Wesley Drive, Wood River Centre, Wood River, IL 62095 | 2007-05-03 |
| 1982734414 | Kathleen Crockett | Physical Therapist | 400 S Main, Wood River, IL 62095 | 2007-03-06 |
| 1336200286 | Johan C Dinkelmann | Chiropractor | 21 E Acton Ave, Wood River, IL 62095 | 2006-12-13 |
| 1760418099 | Hagopian Shoes, LLC | Prosthetic/Orthotic Supplier | 48 E Ferguson Ave, Wood River, IL 62095 | 2006-06-26 |
| 1831354257 | Benjamin Hite | Dentist | 1915 Vaughn Road, Wood River, IL 62095 | 2008-07-24 |
| 1679797294 | Rhonda Nemsky | Developmental Therapist | 400 S Main, Wood River, IL 62095 | 2007-04-13 |
| 1770613218 | Frederic Golden | Psychologist | 400 S Main, Wood River, IL 62095 | 2007-03-06 |
| Find all providers in zip 62095 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275697229 | Bud Polpat Chomhirun | Physical Medicine & Rehabilitation | 1702 Vaughn Rd, Suite 1, Wood River, IL 62095-1898 | 2006-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285256982 | Prm of Illinois | Physical Medicine & Rehabilitation | 625 N Michigan Ave Ste 810, Chicago, IL 60611-3110 | 2020-05-15 |
| 1346807724 | Complete Pain Management LLC | Physical Medicine & Rehabilitation | 16310 S Lincoln Hwy Ste 132, Plainfield, IL 60586-9100 | 2019-05-21 |
| 1376007757 | Jose Angel Munoz Jr. | Physical Medicine & Rehabilitation | 5035 W Parker Ave, Chicago, IL 60639-1603 | 2019-01-30 |
| 1770050668 | Prarie State Rehabilitation, LLC | Physical Medicine & Rehabilitation | 12220 S Cheyenne Dr, Palos Heights, IL 60463-1654 | 2018-10-29 |
| 1053806406 | Naperville Rehab and Medical Clinic PC | Physical Medicine & Rehabilitation | 445 Jackson Ave Ste 102, Naperville, IL 60540-5257 | 2018-06-28 |
| 1457711418 | Elite Pain Medical Group Inc | Physical Medicine & Rehabilitation | 720 South Brom Drive, Suite 201, Naperville, IL 60540 | 2016-03-03 |
| 1992123004 | Bhavana Vaidya Md LLC | Physical Medicine & Rehabilitation | 10601 S Kilbourn Ave, Oak Lawn, IL 60453-5341 | 2014-04-04 |
| 1275966418 | Restorative Health Center Sc | Physical Medicine & Rehabilitation | 430 Barron Blvd, Grayslake, IL 60030-1666 | 2013-08-12 |
| 1629315312 | Chinatown Integrated Medicine Ltd | Physical Medicine & Rehabilitation | 2134b S Archer Ave Fl 2, Chicago, IL 60616-1514 | 2013-01-15 |
| 1760735377 | Suburban Medical & Rehab Clinic, Ltd | Physical Medicine & Rehabilitation | 269 S Roselle Rd, Schaumburg, IL 60193-1636 | 2012-10-19 |
| Find all providers with the same taxonomy | ||||
| City | WOOD RIVER |
| Zip Code | 62095 |
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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.