ELITE PAIN MANAGEMENT, LLC (NPI# 1609257773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609257773 |
| Entity Type | Organization |
| Organization Name | ELITE PAIN MANAGEMENT, LLC |
| Practice Address |
222 E Primrose St Suite E Springfield MO 65807-5206 |
| Practice Telephone | 4175531080 |
| Practice Fax Number | 8884725145 |
| Mailing Telephone | 4175531080 |
| Mailing Fax Number | 8884725145 |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2018-06-20 |
| Authorized Official Name | DR. DAVID M. TONKIN (DOCTOR) |
| Authorized Official Telephone | 4177204991 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | ========= | MO | Suppliers |
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | NATIONAL SUPPLIER CLEARING HOUSE MEDICARE DMEPOS | 7422650001 | 01 |
| MO | MISSOURI DEA LICENSE | FT3614307 | 01 |
| MO | MISSOURI MEDICAL LICENSE | 2007017247 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598304917 | Elite Pain Management, LLC | Durable Medical Equipment & Medical Supplies | 5780 Osage Beach Pkwy Ste 113, Osage Beach, MO 65065-3188 | 2020-01-02 |
| 1447626759 | Elite Pain Management, LLC | Pain Medicine | 331 W Broad St, Lepanto, AR 72354-2202 | 2015-08-20 |
| 1083098115 | Elite Pain Management, LLC | Specialist | 1601 K66 Ste C, Galena, KS 66739-4306 | 2015-07-18 |
| 1457727752 | Elite Pain Management, LLC | Durable Medical Equipment & Medical Supplies | 4237 River Hills Dr, Little River, SC 29566-6444 | 2015-08-20 |
| 1639545940 | Elite Pain Management, LLC | Pain Medicine | 7150 W Sunset Rd Ste 202, Las Vegas, NV 89113-1981 | 2015-08-20 |
| 1376919670 | Elite Pain Management, LLC | Pain Medicine | 2100 Silva Ln, Moberly, MO 65270-3600 | 2015-08-20 |
| Street Address |
222 E PRIMROSE ST SUITE E |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65807-5206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801984497 | Rebecca J Wotherspoon | Pediatrics | 222 E Primrose St, Suite E, Springfield, MO 65807-5206 | 2006-10-10 |
| 1871079640 | Matthew Shahram Manighalam | Family Medicine | 222 E Primrose St, Springfield, MO 65807-5206 | 2018-07-16 |
| 1396958260 | Melissa Jo Kokoszka | Anesthesiology | 222 E Primrose St, Suite E, Springfield, MO 65807-5206 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1598250961 | Kathryn Barber | Nurse Practitioner | 3800 S National Ave Ste 700, Springfield, MO 65807 | 2018-06-27 |
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1740663335 | Sarah E Kirk | Physical Therapist | 3545 S. National Ave, Springfield, MO 65807 | 2015-07-01 |
| 1750713335 | Amanda Ward | Nurse Practitioner | 2150 W Republic Rd Ste 112, Springfield, MO 65807 | 2013-08-06 |
| 1932531126 | Eugenia R Cortez | Counselor | 2124 Chesterfield Blvd., Springfield, MO 65807 | 2013-07-30 |
| 1962742866 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3045 W Republic St, Springfield, MO 65807 | 2013-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| Find all providers in zip 65807 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518313287 | Prairie Bleeding and Clotting Center | Specialist | 105 S Amos Ave, Springfield, IL 62704-1528 | 2016-05-11 |
| 1043666894 | Nina Olmeda | Specialist | 35 Braywood Cir, Springfield, MA 01151-1036 | 2016-05-11 |
| 1144681214 | Vickiejean Phillips | Specialist | 1332 35th St, Springfield, OR 97478-5554 | 2016-03-16 |
| 1811354681 | Monica M Jones | Specialist | 118 Victory Rd Apt 315, Springfield, NJ 07081-1342 | 2016-01-25 |
| 1215334941 | Brandon Avenue Pediatrics | Specialist | 6126 Brandon Ave, Springfield, VA 22150-2610 | 2014-11-24 |
| 1558766006 | Ozark Retina & Macula | Specialist | 1230 E Kingsley St Ste A, Springfield, MO 65804-7231 | 2014-10-27 |
| 1396146411 | Colin Bailey | Specialist | 155 S Tuttle Rd, Springfield, OH 45505-1560 | 2014-09-08 |
| 1659771350 | Ronnie L. Jackson Md | Specialist | 496 Northcrest Dr, Springfield, TN 37172-3972 | 2014-08-29 |
| 1659781136 | Ashley Foucha | Specialist | 1342 E Primrose St Ste A, Springfield, MO 65804-4224 | 2014-05-05 |
| 1225452881 | Elizabeth Creps | Specialist | 1623 21st St Ste B, Springfield, OR 97477-3417 | 2014-02-18 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65807 |
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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.