MICHIANA SPINE, SPORTS & OCCUPATIONAL REHAB, PC (NPI# 1386902013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386902013 |
| Entity Type | Organization |
| Organization Name | MICHIANA SPINE, SPORTS & OCCUPATIONAL REHAB, PC |
| Practice Address |
24 N Saint Joseph Ave Ste B Niles MI 49120-2263 |
| Mailing Address |
3740 Edison Lakes Pkwy Mishawaka IN 46545-3474 |
| Practice Telephone | 5742524150 |
| Practice Fax Number | 5742524159 |
| Mailing Telephone | 5742524150 |
| Mailing Fax Number | 5742524159 |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2012-05-01 |
| Authorized Official Name | KEVIN G DREW (OWNER) |
| Authorized Official Telephone | 5742524150 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
4301070312 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407115884 | Michiana Spine, Sports & Occupational Rehab, PC | Pain Medicine | 2500 Niles Rd Ste 3, Saint Joseph, MI 49085-3225 | 2012-05-07 |
| Street Address |
24 N SAINT JOSEPH AVE STE B |
| City | NILES |
| State | MI |
| Zip Code | 49120-2263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093285652 | The Caerus Group LLC | Clinic/Center | 732 S. 11th St #197, Niles, MI 49120 | 2018-11-27 |
| 1306316971 | Vicki L Yarbro | Physical Therapist | 6 Longmeadow Village Dr. Suite 3, Niles, MI 49120 | 2018-11-27 |
| 1063831469 | Aaron Joseph Lanning | Nurse Practitioner | 42 N Saint Joseph Ave Ste 300, Niles, MI 49120 | 2014-04-14 |
| 1740601186 | Terrianne Klaeren | Occupational Therapist | 1009 Almaugus Drive, Niles, MI 49120 | 2014-01-03 |
| 1124469366 | All Needs Senior Services, Inc. | Home Health | 1723 Pucker Street Dr, Suite A, Niles, MI 49120 | 2013-07-16 |
| 1902105034 | Nile Family Pharmacy LLC | Pharmacy | 70 E. State St., Niles, MI 49120 | 2011-03-15 |
| 1629240734 | Karen L Palmer | Counselor | 115 S St Joseph Ave, Niles, MI 49120 | 2008-03-28 |
| 1124218391 | Melissa A Longley | Social Worker | 333 N. Second Street, Suite 303, Niles, MI 49120 | 2007-07-25 |
| 1841410727 | Periza Zaninovic | Dentist | 123 Marmont Street, Niles, MI 49120 | 2007-04-26 |
| 1477629087 | Stephen Williams Tankersley | Dentist | 226 S Lincoln Ave, Niles, MI 49120 | 2006-11-27 |
| Find all providers in zip 49120 | ||||
| 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 |
|---|---|---|---|---|
| 1558903294 | Comprehensive Pain Specialists, Pllc | Pain Medicine | 4302 Bay City Rd, Midland, MI 48642-6014 | 2019-10-15 |
| 1437715232 | Comprehensive Pain Specialists, Pllc | Pain Medicine | 705 E Frank St, Caro, MI 48723 | 2019-05-16 |
| 1083175913 | Bella Treatment Center PC | Pain Medicine | 28763 Northwestern Hwy Ste 100, Southfield, MI 48034-1842 | 2019-03-25 |
| 1245795848 | Advanced Pain Management Specialists, LLC | Pain Medicine | 46325 W 12 Mile Rd Ste 335, Novi, MI 48377-2464 | 2019-02-07 |
| 1356738686 | Genesee Pain Associates PC | Pain Medicine | 4468 Oakbridge Dr, Flint, MI 48532-5422 | 2015-04-24 |
| 1457745150 | Strategy Anesthesia Michigan Pllc | Pain Medicine | 13460 Fort St, Southgate, MI 48195-1138 | 2015-03-20 |
| 1407115884 | Michiana Spine, Sports & Occupational Rehab, PC | Pain Medicine | 2500 Niles Rd Ste 3, Saint Joseph, MI 49085-3225 | 2012-05-07 |
| 1225302821 | Pain Clinic Management Group, Pllc | Pain Medicine | 35634 Dequindre Rd, Sterling Heights, MI 48310-4288 | 2012-02-28 |
| 1740567163 | Northville Pain Specialists Plc | Pain Medicine | 215 E. Main Street, Suite 201, Northville, MI 48167-1686 | 2011-11-14 |
| 1639309388 | John Birgiolas | Pain Medicine | 2147 Health Dr Sw, Wyoming, MI 49519 | 2009-07-15 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MICHIANA SPINE, SPORTS & OCCUPATIONAL REHAB, PC.
| 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.