ILUMINA LIFE CENTER, P.C. (NPI# 1942686753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942686753 |
| Entity Type | Organization |
| Organization Name | ILUMINA LIFE CENTER, P.C. |
| Practice Address |
418 N Logan Blvd Suite B Burnham PA 17009-1816 |
| Mailing Address |
136 Jaycee Dr Suite 10 Johnstown PA 15904-3650 |
| Practice Telephone | 7172423900 |
| Practice Fax Number | 7172488590 |
| Mailing Telephone | 8144674055 |
| Mailing Fax Number | 8142628161 |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2015-08-04 |
| Authorized Official Name | MELODY COOPER (CEO) |
| Authorized Official Telephone | 8144674055 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
MD423112 | PA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467852996 | Ilumina Life Center, P.C. | Clinic/Center | 211 Granite Run Dr Ste 221, Lancaster, PA 17601 | 2014-09-03 |
| 1295101715 | Ilumina Life Center, P.C. | Pain Medicine | 507 Tire Hill Rd, Suite 100, Johnstown, PA 15905-7311 | 2015-08-19 |
| Street Address |
418 N LOGAN BLVD SUITE B |
| City | BURNHAM |
| State | PA |
| Zip Code | 17009-1816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407825417 | Pratibha V Vakharia | Specialist | 418 N Logan Blvd, Burnham, PA 17009-1816 | 2006-03-14 |
| 1124498746 | Pain Medicine of York, LLC | Physical Medicine & Rehabilitation | 418 N Logan Blvd, Burnham, PA 17009-1816 | 2015-09-25 |
| 1518386770 | Allergy & Asthma Specialist LLC | Specialist | 418 N Logan Blvd, Burnham, PA 17009-1816 | 2014-04-15 |
| 1528354271 | Lighthouse Medical LLC | Physical Medicine & Rehabilitation | 418 N Logan Blvd, Suite A, Burnham, PA 17009-1816 | 2011-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215153929 | Jeffery A. Gilbert | Internal Medicine | 217 South Logan Blvd., Burnham, PA 17009 | 2007-04-18 |
| 1679902571 | Angela Deamer | Case Manager/Care Coordinator | 543 E Freedom Ave, Burnham, PA 17009-1306 | 2013-11-01 |
| 1962855072 | Happy Valley Hab-aide Co. | Community/Behavioral Health | 543 E Freedom Ave, Burnham, PA 17009-1306 | 2016-07-14 |
| 1831252972 | Juniata Valley Foot and Ankle Associates | Durable Medical Equipment & Medical Supplies | 215 N Beech St, Burnham, PA 17009-1600 | 2006-12-19 |
| 1700098084 | Family Health Associates Orthopedics | Orthopaedic Surgery | 215 N Beech St, Burnham, PA 17009-1600 | 2007-05-07 |
| 1972643450 | Lewistown Ambulatory Care Corporation | Internal Medicine | 215 N Beech St, Burnham, PA 17009-1600 | 2007-02-07 |
| 1316950348 | Katherine Terese Harvatine | Optometrist | 231 N Logan Blvd, Wise Eyes Optical, Burnham, PA 17009-1813 | 2006-08-14 |
| 1194958413 | Harvatine Optometry, Inc. | Clinic/Center | 231 N Logan Blvd, Burnham, PA 17009-1813 | 2009-09-03 |
| 1083718829 | Pennsylvania Cvs Pharmacy, L.L.C. | Pharmacy | 404 N Logan Blvd, Burnham, PA 17009-1816 | 2006-09-12 |
| 1255341145 | Dicks Home Care Inc | Durable Medical Equipment & Medical Supplies | 224 N Logan Blvd Ste 8, Burnham, PA 17009-1819 | 2006-08-09 |
| Find all providers in zip 17009 | ||||
| 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 |
|---|---|---|---|---|
| 1063055200 | Sepa Lab - Bristol | Pain Medicine | 200 Rittenhouse Circle, Ste 1a East, Bristol, PA 19007-1619 | 2019-10-21 |
| 1033776257 | Restorative Pain Care LLC | Pain Medicine | 409 Portland Dr, Broomall, PA 19008-4120 | 2019-05-22 |
| 1104482850 | Keystone Pain Consultants & Interventional Spine Specialists PC | Pain Medicine | 2000 Oxford Dr Ste 303, Bethel Park, PA 15102-1841 | 2019-05-17 |
| 1891250767 | Regenerative Pain Specialist, PC | Pain Medicine | 725 Darby Paoli Rd, Villanova, PA 19085-1008 | 2019-02-05 |
| 1649766742 | Smr Pain Management | Pain Medicine | 213 Reeceville Rd Ste 10, Coatesville, PA 19320-1532 | 2018-07-02 |
| 1720463938 | Lancaster Medical Group, LLC | Pain Medicine | 233 College Ave Ste 101, Lancaster, PA 17603-3385 | 2015-07-29 |
| 1760725246 | Pittsburgh Pain Physicians | Pain Medicine | 119 Vip Dr Ste G015, Wexford, PA 15090-7976 | 2013-04-02 |
| 1417199217 | Kenneth Zahl | Pain Medicine | 175 E Brown St Ste 201b, E Stroudsburg, PA 18301-3098 | 2009-03-25 |
| 1316127376 | St. Luke's Physician Group, Inc. | Pain Medicine | 1534 Park Ave Ste 310, Quakertown, PA 18951-1087 | 2007-11-07 |
| 1922111764 | Erie Spine and Pain Management PC | Pain Medicine | 2620 Sigsbee Street, Erie, PA 16508 | 2006-08-16 |
| Find all providers with the same taxonomy | ||||
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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.