NORTHWEST PAIN MANAGEMENT INC (NPI# 1104991405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104991405 |
| Entity Type | Organization |
| Organization Name | NORTHWEST PAIN MANAGEMENT INC |
| Other Organization Name | INTRACTABLE PAIN CENTERS |
| Practice Address |
897 Royal Ave Suite C Medford OR 97504-6121 |
| Practice Telephone | 5417701650 |
| Practice Fax Number | 5417732470 |
| Mailing Telephone | 5417701650 |
| Mailing Fax Number | 5417732470 |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. THOMAS JOHN PURTZER (PRESIDENT) |
| Authorized Official Telephone | 5417701650 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
12880 | OR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 146753 | 05 | |
| OR | RAILROAD MEDICARE | DD5160 | 01 |
| Other Name | Type Code |
|---|---|
| Intractable Pain Centers | Doing Business As Name - Organization |
| Street Address |
897 ROYAL AVE SUITE C |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-6121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912963661 | Larry Jou Maukonen | Psychiatry & Neurology | 897 Royal Ave, Suite B, Medford, OR 97504 | 2006-04-21 |
| 1164642682 | Southern Oregon Neurology PC | Psychiatry & Neurology | 897 Royal Ave, Ste B, Medford, OR 97504-6121 | 2007-04-26 |
| 1821054578 | John Anderson Melson | Psychiatry & Neurology | 897 Royal Ave, Ste B, Medford, OR 97504 | 2006-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942543764 | Neelam M. Thacker, M.d. | Clinic/Center | 101 Main St, #210, Medford, MA 02155-4540 | 2013-03-29 |
| 1033491766 | H. Gregory Ota, M.d., P.c | Clinic/Center | 101 Main St, Suite 216, Medford, MA 02155-4540 | 2011-09-20 |
| 1134158983 | Cardiovascular Institute of Southern Oregon, LLC | Clinic/Center | 520 Medical Center Dr, Suite 150, Medford, OR 97504-4334 | 2006-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063026466 | Kyle D. Homertgen Bend Osteopathic Care PC | Clinic/Center | 147 Sw Shevlin Hixon Dr Ste 204, Bend, OR 97702-1137 | 2020-09-02 |
| 1396252177 | Rising Heart Healing | Clinic/Center | 492 E 13th Ave Ste 208, Eugene, OR 97401-4268 | 2018-01-03 |
| 1417316191 | Ronald Guiley Od, Mph, PC | Clinic/Center | 63455 N Hwy 97, Ste 75, Bend, OR 97703 | 2016-02-23 |
| 1932566320 | Dr Steven Clark and Associates, LLC | Clinic/Center | 697 Nw Division St, Gresham, OR 97030-5424 | 2016-01-15 |
| 1174907638 | Bridgeton Chiropractic, LLC | Clinic/Center | 10350 N Vancouver Way # 92, Portland, OR 97217-7530 | 2015-07-15 |
| 1356745301 | Deschutes Health LLC | Clinic/Center | 612 Ne Savannah Dr, Suite 1, Bend, OR 97701-4874 | 2014-10-20 |
| 1447677059 | Ent Facial Plastic and Laser Center, Inc | Clinic/Center | 600 Nw 11th St Ste E21, Hermiston, OR 97838-8603 | 2014-03-20 |
| 1154661163 | Sundara Acupuncture LLC | Clinic/Center | 17175 Sw Lisa St, Beaverton, OR 97006-4185 | 2013-02-28 |
| 1053659938 | Dedicated Sleep, LLC | Clinic/Center | 21260 S Springwater Rd, Estacada, OR 97023-9650 | 2013-01-28 |
| 1912241746 | Portland Preventive Cardiology LLC | Clinic/Center | 8855 Sw Canyon Ln, Portland, OR 97225-3411 | 2012-11-16 |
| 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.