COMPREHENSIVE PAIN CENTER OF MISSISSIPPI (NPI# 1124275565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124275565 |
| Entity Type | Organization |
| Organization Name | COMPREHENSIVE PAIN CENTER OF MISSISSIPPI |
| Practice Address |
129 Fountains Blvd Madison MS 39110 |
| Practice Telephone | 7693000730 |
| Practice Fax Number | 6019492782 |
| Mailing Telephone | 6019499994 |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | DR. LEONEL KEVIN VANCE (OWNER) |
| Authorized Official Telephone | 7693000730 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
16855 | MS | Allopathic & Osteopathic Physicians |
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
16855 | MS | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1190 N State St, Suite 202, Jackson, MS 392022413 | 6019499994 |
| Street Address |
129 FOUNTAINS BLVD |
| City | MADISON |
| State | MS |
| Zip Code | 39110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518920511 | Mary Ann Jones | Nurse Practitioner | 129 Fountains Blvd, Madison, MS 39110-6318 | 2006-04-10 |
| 1194232660 | Kellie J Watkins | Nurse Practitioner | 129 Fountains Blvd, Madison, MS 39110 | 2018-01-05 |
| 1902322787 | Paula Leigh Bland | Nurse Practitioner | 129 Fountains Blvd, Madison, MS 39110-6344 | 2017-08-14 |
| 1134674153 | Newcare Md, LLC | Clinic/Center | 129 Fountains Blvd, Suite 101, Madison, MS 39110-6344 | 2016-08-19 |
| 1609024835 | June G. Kimbrough | Nurse Practitioner | 129 Fountains Blvd, Madison, MS 39110-6318 | 2008-08-29 |
| 1669507943 | Leonel Kevin Vance | Anesthesiology | 129 Fountains Blvd, Ste 201, Madison, MS 39110 | 2007-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134784689 | Therapy South - Gluckstadt LLC | Physical Therapist | 1716 Us 51, Ste N, Madison, MS 39110 | 2019-05-09 |
| 1871054098 | Summit Medical Solutions | Durable Medical Equipment & Medical Supplies | 107 Azalea Street, Madison, MS 39110 | 2019-03-29 |
| 1912488198 | Madison Medical Compounding Pharmacy | Pharmacy | 111 Fountains Blvd. Building B Ste. A, Madison, MS 39110 | 2018-08-24 |
| 1679061469 | Nuvena Vein Clinic | Anesthesiology | 120 Fountains Blvd, Madison, MS 39110 | 2018-04-26 |
| 1467960484 | Brick City Drugs, LLC | Durable Medical Equipment & Medical Supplies | 159 Fountains Blvd, Madison, MS 39110 | 2018-01-11 |
| 1093227589 | Hannah Monk Hawthorne | Counselor | 930 Ebenezer Blvd., Suite D, Madisin, MS 39110 | 2017-10-25 |
| 1548786650 | Kimberly Allen | Pharmacist | 1100 Us- 51, Madison, MS 39110 | 2017-08-21 |
| 1891218186 | Delta Elizabeth Stark | Chiropractor | 1085 Gluckstadt Rd., Bld 300 Ste E, Madison, MS 39110 | 2017-07-19 |
| 1861914848 | Laura Hartlein | Dietitian, Registered | 200 Park Circle Dr. #2, Flowood, MS 39110 | 2017-07-12 |
| 1831620608 | Ona Irby | Occupational Therapist | 105 Munich Dr, Madison, MS 39110 | 2017-03-23 |
| Find all providers in zip 39110 | ||||
| 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 |
|---|---|---|---|---|
| 1407079551 | Wv Spine and Pain Clinic | Pain Medicine | 340 State St, Madison, WV 25130-1365 | 2007-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639317274 | Robert A Wiemer Jr. | Pain Medicine | 528-f Klondike Road, Long Beach, MS 39560 | 2009-02-03 |
| 1922218627 | Robert Fortier Bensen | Pain Medicine | 445 Security Sq, Gulfport, MS 39507-1922 | 2007-05-23 |
| 1811098874 | Laurel Pain Clinic Pa | Pain Medicine | 1706 W 12th St, Laurel, MS 39440-2559 | 2006-09-25 |
| 1922092881 | Eric Pearson | Pain Medicine | 1001 14th St, Meridian, MS 39301-4458 | 2005-09-07 |
| 1497752760 | Fani B Manney | Pain Medicine | #4 Doctors Dr, Suite C, Ocean Springs, MS 39564 | 2005-07-01 |
| 1417953050 | Steven Thomas Richey | Pain Medicine | 122 Airways Pl, Southaven, MS 38671-5872 | 2005-06-27 |
| 1316558893 | Mississippi Pain Management, Pllc | Pain Medicine | 1080 River Oaks Dr Ste B103, Flowood, MS 39232-7602 | 2020-08-10 |
| 1083193031 | Bacas Interventional Pain Management, LLC | Pain Medicine | 1430 Highway 4 E, Holly Springs, MS 38635-2140 | 2018-08-10 |
| 1356848014 | Flowood Pain Center, LLC | Pain Medicine | 120 Stone Creek Blvd Ste 500, Flowood, MS 39232-8210 | 2018-04-10 |
| 1134596760 | Pain Partners, LLC | Pain Medicine | 1001 14th St, Meridian, MS 39301-4458 | 2015-08-31 |
| 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.