SOUTHWEST SPINE AND PAIN CARE SPECIALISTS LLC (NPI# 1144509985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144509985 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST SPINE AND PAIN CARE SPECIALISTS LLC |
| Other Organization Name | SOUTHWEST SPINE AND PAIN CENTER |
| Practice Address |
652 S Medical Center Dr Ste 110 Saint George UT 84790-7017 |
| Practice Telephone | 4356562828 |
| Mailing Telephone | 4356562828 |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2020-03-11 |
| Authorized Official Name | JON B OBRAY (MANAGING PARTNER) |
| Authorized Official Telephone | 4352150230 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Southwest Spine and Pain Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508368465 | Southwest Spine and Pain Care Specialists LLC | Community/Behavioral Health | 1085 S Bluff St Ste 200, Saint George, UT 84770-5245 | 2018-03-06 |
| 1700234499 | Southwest Spine and Pain Care Specialists LLC | Anesthesiology | 1303 N Main St, Cedar City, UT 84721-9746 | 2016-06-02 |
| 1134582570 | Southwest Spine and Pain Care Specialists LLC | Anesthesiology | 630 E 1400 N, Suite 135, Logan, UT 84341-2534 | 2016-04-02 |
| Street Address |
652 S MEDICAL CENTER DR STE 110 |
| City | SAINT GEORGE |
| State | UT |
| Zip Code | 84790-7017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235761909 | Brandon Don Gust | Physical Therapist | 652 S Medical Center Dr, Saint George, UT 84790-7049 | 2020-02-10 |
| 1558918367 | Jenna T. Summerhays | Nurse Practitioner | 652 S Medical Center Dr, Saint George, UT 84790-7049 | 2019-08-26 |
| 1336623933 | Stephanie Lister | Speech-Language Pathologist | 652 S Medical Center Dr, Saint George, UT 84790-7049 | 2018-09-19 |
| 1265977995 | Jose M Del Castillo | Specialist/Technologist | 652 S Medical Center Dr, Suite 120, Saint George, UT 84790-7049 | 2017-01-04 |
| 1689071060 | Virginia Fischer | Nurse Practitioner | 652 S Medical Center Dr, Saint George, UT 84790-7049 | 2014-12-01 |
| 1659505584 | Mark Toy Yoder | Physician Assistant | 652 S Medical Center Dr, Suite 420, Saint George, UT 84790-7049 | 2009-05-06 |
| 1003898198 | Jeffrey A Wright | Physician Assistant | 652 S Medical Center Dr, Ste 110, Saint George, UT 84790-7049 | 2005-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342713 | Katrina Poulsen | Student in an Organized Health Care Education/Training Program | 617 East Rriverside Dr, Ste 301, St. George, UT 84790 | 2020-10-08 |
| 1124643226 | Desert View Eyecare | Optometrist | 15 South River Road St. 150, St. George, UT 84790 | 2020-06-15 |
| 1366066417 | Benjamin Todd Lloyd | Dentist | 1683 E. Wolf Hole Dr, St. George, UT 84790 | 2020-06-04 |
| 1801434584 | Jennifer M Putnam | Marriage & Family Therapist | 321 North Mall Drive, Vw103, St. George, UT 84790 | 2019-12-12 |
| 1326683012 | Red Mountain Counseling and Education | Counselor | 321 No Mall Dr, Vw 103, St. George, UT 84790 | 2019-11-17 |
| 1295376002 | Karynne Kimberly Simpson | Behavior Technician | 280 N 1680 E U1, St. George, UT 84790 | 2019-10-02 |
| 1962053017 | Mikala Larsen | Nurse Practitioner | 1380 S Medical Center Dr., Saint George, UT 84790 | 2019-09-20 |
| 1326690678 | Joe Ballent | Student in an Organized Health Care Education/Training Program | 1526 S Medical Center Dr Ste 224a, St George, UT 84790 | 2019-07-16 |
| 1558923854 | David Pace | Optometrist | 749 South River Rd, St. George, UT 84790 | 2019-07-08 |
| 1639734924 | Mariah Ann Mertlich | Behavioral Analyst | 280 N 1680 E, U1, St. George, UT 84790 | 2019-05-02 |
| Find all providers in zip 84790 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760487870 | Jeffrey Evan Faaberg | Anesthesiology | 5790 Memorial Boulevard, Saint George, SC 29477 | 2005-06-15 |
| 1871762450 | Desert Pain Specialists, LLC | Anesthesiology | 617 E Riverside Dr Ste 301, Saint George, UT 84790-8722 | 2008-02-27 |
| 1689851941 | Eric A Evans Md PC | Anesthesiology | 640 E 700 S Ste 10b, Saint George, UT 84770-4036 | 2008-01-29 |
| 1376574855 | Crowfield Pain Center | Anesthesiology | 5790 Memorial Boulevard, Saint George, SC 29477 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952865412 | Avail Medical LLC | Anesthesiology | 5742 S 1475 E Ste 200, South Ogden, UT 84403-4856 | 2019-01-29 |
| 1033597257 | Ashley Renee Donaldson | Anesthesiology | Spinal Interventions, 280 W River Park Drive Suite 200, Provo, UT 84604 | 2015-05-07 |
| 1609204338 | Interventional Spine & Pain Management | Anesthesiology | 5801 S Fashion Blvd Ste 180, Murray, UT 84107-8135 | 2013-10-15 |
| 1225387491 | Clinton D. Olsen | Anesthesiology | 280 W River Park Dr, Suite 200, Provo, UT 84604-5793 | 2012-09-04 |
| 1134429384 | Intermountain Medical Monitoring LLC | Anesthesiology | 1306 Deer Crest, Fruit Heights, UT 84037 | 2010-10-21 |
| 1861622219 | Jeremy Joyal | Anesthesiology | 11760 S 700 E Ste 112, Draper, UT 84020-6605 | 2009-07-20 |
| 1205058294 | Joseph Courtney Empey | Anesthesiology | 617 E Riverside Dr Ste 301, St George, UT 84790-8722 | 2007-05-02 |
| 1962439570 | Gordon Petty George, Md, PC | Anesthesiology | 800 N 700 W, Ste 340a, Orem, UT 84057 | 2006-06-27 |
| 1770558090 | Bryan C Hoelzer | Anesthesiology | 320 River Park Dr Ste 255, Provo, UT 84604 | 2006-02-21 |
| 1164421053 | Dale Gerald Stott | Anesthesiology | 301 N 200 E, Suite 2a, St George, UT 84770-3010 | 2005-07-21 |
| Find all providers with the same taxonomy | ||||
| City | SAINT GEORGE |
| Zip Code | 84790 |
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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.