TRI-STATE ADVANCED PAIN MANAGEMENT (NPI# 1306108618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306108618 |
| Entity Type | Organization |
| Organization Name | TRI-STATE ADVANCED PAIN MANAGEMENT |
| Practice Address |
444 S Main St Suite 133 Madisonville KY 42431-2846 |
| Mailing Address |
3332 Villa Pt Suite 104 Owensboro KY 42303-7818 |
| Practice Telephone | 2708254732 |
| Practice Fax Number | 2708254733 |
| Mailing Telephone | 2706845679 |
| Mailing Fax Number | 2706845753 |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2013-06-10 |
| Authorized Official Name | DR. SUK KI KIM (PRESIDENT) |
| Authorized Official Telephone | 2706845679 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | TRI-STATE ADVANCED PAIN MANAGEMENT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
17728 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 64177280 | 05 |
| Street Address |
444 S MAIN ST SUITE 133 |
| City | MADISONVILLE |
| State | KY |
| Zip Code | 42431-2846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306813431 | Diana M. Stulc, Psc | Family Medicine | 444 S Main St, Madisonville, KY 42431-2871 | 2006-03-08 |
| 1578052171 | Mary Anne E Odaniel | Physical Therapist | 444 S Main St, Madisonville, KY 42431 | 2018-05-09 |
| 1417467960 | Regina J. Sisk | Nurse Practitioner | 444 S Main St, Madisonville, KY 42431-2846 | 2017-10-10 |
| 1548786783 | Kayla Marie Hanks | Physical Therapist | 444 S Main St, Madisonville, KY 42431-2846 | 2017-08-18 |
| 1669997821 | Kimberlee Beth Taylor | Physical Therapist | 444 S Main St, Madisonville, KY 42431-2846 | 2017-08-09 |
| 1972966612 | Rebecca V Tauil | Physician Assistant | 444 S Main St, Madisonville, KY 42431-2846 | 2016-03-31 |
| 1992173330 | Peggy L. Harris | Registered Nurse | 444 S Main St, Madisonville, KY 42431-2846 | 2015-09-02 |
| 1528471208 | Jeana L Townsend | Nurse Practitioner | 444 S Main St, Madisonville, KY 42431-2846 | 2014-06-10 |
| 1891129250 | John W Horn | Physical Therapist | 444 S Main St, Madisonville, KY 42431-2846 | 2013-08-21 |
| 1740587450 | Tracey Lynn Ervin | Pharmacist | 444 S Main St, Madisonville, KY 42431-2846 | 2011-02-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750846309 | Sarah Davenport Ziegler | Registered Nurse | 3050 Nebo Rd, Madisonville, KY 42431 | 2019-02-08 |
| 1134604903 | Kelsey Dawn Wilson | Occupational Therapist | 425 Island Ford Rd, Madisonville, KY 42431 | 2018-09-27 |
| 1174006209 | Shaun Vickery | Physical Therapist | 425 Island Ford Road, Madisonville, KY 42431 | 2018-09-14 |
| 1881115384 | Filza Tajik | Speech-Language Pathologist | 1305-1 W. Noel Ave, Unit 1, Madisonville, KY 42431 | 2017-07-05 |
| 1245769280 | Susan Hart | Student in an Organized Health Care Education/Training Program | 200 Clinic Drive, Third North, Madisonville, KY 42431 | 2017-06-05 |
| 1811363880 | Cory Eakins | Nutritionist | 2223 S Main St, Madisonville, KY 42431 | 2015-08-13 |
| 1932598257 | Deidra Boyken | Counselor | 145 E. Center Street Suite 1d, Madisonville, KY 42431 | 2015-01-12 |
| 1841602398 | Jessica France | Occupational Therapist | 339 S Seminary St, Madisonville, KY 42431 | 2014-06-02 |
| 1497097562 | Sunrise Children's Services | Community/Behavioral Health | 1079 Thornberry Dr Ste 203, Madisonville, KY 42431 | 2013-03-26 |
| 1013275023 | Creasha King | Counselor | 1079 Thornberry Dr Ste B, Madisonville, KY 42431 | 2012-04-26 |
| Find all providers in zip 42431 | ||||
| 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 |
|---|---|---|---|---|
| 1053888560 | Pain Management Centers of America, Psc | Pain Medicine | 200 Clinic Dr Fl 6, Madisonville, KY 42431-1661 | 2018-11-01 |
| 1720585698 | Advanced Pain Care Clinic Psc | Pain Medicine | 200 Clinic Dr Fl 6, Madisonville, KY 42431-1661 | 2018-04-09 |
| 1043712417 | Advanced Pain Care Clinic Psc | Pain Medicine | 200 Clinic Dr Fl 6, Madisonville, KY 42431-1661 | 2018-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528554474 | Hillcrest Pain & Spine Pllc | Pain Medicine | 853 Lane Allen Rd Ste 217, Lexington, KY 40504 | 2018-07-03 |
| 1346766441 | Integrated Pain Management of Kentucky LLC | Pain Medicine | 210 Thomas More Pkwy Ste B, Crestview Hills, KY 41017-3429 | 2017-08-21 |
| 1578981718 | Restore Rehabilitation | Pain Medicine | 6400 Dutchmans Pkwy Ste 80, Louisville, KY 40205-3340 | 2014-04-04 |
| 1508201898 | Center for Pain Management | Pain Medicine | 440 B High St, Bowling Green, KY 42101 | 2013-05-01 |
| 1689994154 | Cumberland Brain and Spine, Pllc | Pain Medicine | 1641 Scottsville Rd, Bowling Green, KY 42104-3244 | 2010-06-08 |
| 1235358243 | Gary L Reasor, Md P.s.c | Pain Medicine | 4121 Dutchmans Ln Ste 606, Louisville, KY 40207-4725 | 2007-04-25 |
| 1407995517 | Cassari Pain Treatment Center Inc | Pain Medicine | 4010 Dupont Circle #430, Louisville, KY 40207 | 2007-02-05 |
| 1922186378 | Tri-state Advanced Pain Management Pllc | Pain Medicine | 3332 Villa Pt Ste 104, Owensboro, KY 42303-7818 | 2006-11-02 |
| 1164518080 | David P Bosomworth II | Pain Medicine | 279 Kings Daughters Dr Ste 100, Frankfort, KY 40601 | 2006-10-05 |
| 1639263338 | Bluegrass Pain Management, Psc | Pain Medicine | 1760 Nicholasville Road, Suite 503, Lexington, KY 40503 | 2006-10-03 |
| Find all providers with the same taxonomy | ||||
| City | MADISONVILLE |
| Zip Code | 42431 |
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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.