TRI-STATE MEDICAL SPECIALISTS LLC (NPI# 1649598426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649598426 |
| Entity Type | Organization |
| Organization Name | TRI-STATE MEDICAL SPECIALISTS LLC |
| Other Organization Name | TRISTATE PAIN INSTITUTE |
| Practice Address |
1510 E Wagon Wheel Ln Ste 110 Fort Mohave AZ 86426-6698 |
| Mailing Address |
Po Box 10966 Fort Mohave AZ 86427-0966 |
| Practice Telephone | 9287883333 |
| Practice Fax Number | 9287883555 |
| Mailing Telephone | 9287883333 |
| Mailing Fax Number | 9287883555 |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2018-09-13 |
| Authorized Official Name | DR. BENJAMIN H VENGER (OWNER) |
| Authorized Official Telephone | 9287883333 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207T00000X | Neurological Surgery | 20605 | AZ | Allopathic & Osteopathic Physicians |
| N | 207T00000X | Neurological Surgery | 5573 | NY | Allopathic & Osteopathic Physicians |
| N | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
20605 | AZ | Allopathic & Osteopathic Physicians |
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
5573 | NV | Allopathic & Osteopathic Physicians |
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | AP8599 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | AP3760 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP8599 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
AP8599 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 527366 | 05 | |
| AZ | MEDICARE RAILROAD GROUP PIN | DQ4807 | 01 |
| Other Name | Type Code |
|---|---|
| TriState Pain Institute | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811464118 | Tri-state Medical Specialists LLC | Neurological Surgery | 9555 South Eastern Avenue, Ste. 210, Henderson, NV 89121 | 2018-10-25 |
| 1023302643 | Tri-state Medical Specialists LLC | Non-Pharmacy Dispensing Site | 1510 Wagon Wheel Lane, Suite 110, Fort Mohave, AZ 86426-6698 | 2011-05-31 |
| Street Address |
1510 E WAGON WHEEL LN STE 110 |
| City | FORT MOHAVE |
| State | AZ |
| Zip Code | 86426-6698 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780804583 | William R Kelley Md Prof Corp | Radiology | 1510 E Wagon Wheel Ln Ste 110, Fort Mohave, AZ 86426-6698 | 2007-04-26 |
| 1326558222 | Catherine R Nevels | Pain Medicine | 1510 E Wagon Wheel Ln Ste 110, Fort Mohave, AZ 86426-6698 | 2017-10-05 |
| 1477072130 | Okey Iloegbunam | Pain Medicine | 1510 E Wagon Wheel Ln Ste 110, Fort Mohave, AZ 86426-6698 | 2017-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831740687 | Melissa Janos | Pharmacist | 4823 S, Az-95, Fort Mojave, AZ 86426 | 2019-09-24 |
| 1659774909 | Nicole Eileen Cash | Nurse Practitioner | 5653 S Highway 95 Ste A, Fort Mohave, AZ 86426 | 2014-10-01 |
| 1780009621 | Valley View Physician Practices, LLC | Physical Medicine & Rehabilitation | 5300 S. Highway 95, Ste. D., Ft. Mohave, AZ 86426 | 2014-03-02 |
| 1982840872 | Leticia Alcala | Massage Therapist | 5455 Hwy 95, Fort Mohave, AZ 86426 | 2008-12-23 |
| 1730387432 | Steven Dewayne Smart | Physical Therapist | 1988 Gemini St, Fort Mohave, AZ 86426 | 2007-07-05 |
| 1154543569 | Jonathan M. Brown, D.o., P.C. | Otolaryngology | 5300 South Highway 95, Suite M, Fort Mohave, AZ 86426 | 2007-05-03 |
| 1205931839 | Jennifer Lind Womack | Dietitian, Registered | 5300 S. Highway 95 Ste A, Fort Mohave, AZ 86426 | 2006-09-14 |
| 1053421057 | Kaye A Cunningham Md PC | Family Medicine | 5653 Hwy 95, Suite A, Fort Mohave, AZ 86426 | 2006-08-30 |
| 1780790576 | American Medical Imaging Inc | Radiology | 1517 E Aztec Ln, Fort Mohave, AZ 86426 | 2006-08-22 |
| 1902833817 | Allen E Stout | Chiropractor | 5130 Hwy 95, Fort Mohave, AZ 86426 | 2006-06-27 |
| Find all providers in zip 86426 | ||||
| Taxonomy Code | 208VP0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Pain Medicine |
| Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient’s pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies. |
| Notes: Source: American Academy of Pain Medicine, www.painmed.org - Additional Resources:The American Board of Pain Medicine provides Board Certification. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326558222 | Catherine R Nevels | Pain Medicine | 1510 E Wagon Wheel Ln Ste 110, Fort Mohave, AZ 86426-6698 | 2017-10-05 |
| 1477072130 | Okey Iloegbunam | Pain Medicine | 1510 E Wagon Wheel Ln Ste 110, Fort Mohave, AZ 86426-6698 | 2017-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992364665 | Style Therapeutics | Pain Medicine | 10645 N Tatum Blvd # 200-643, Phoenix, AZ 85028-3068 | 2019-06-06 |
| 1497241079 | Saguaro Treatment Center | Pain Medicine | 5533 E. Bell Rd #111, Scottsdale, AZ 85254 | 2018-07-06 |
| 1427574284 | Hang Doan | Pain Medicine | 12640 W Bethany Home Rd, Litchfield Park, AZ 85340-9599 | 2017-08-14 |
| 1962949354 | Waheeda Siddiqui Ahmed | Pain Medicine | 18185 N 83rd Ave Ste 107, Glendale, AZ 85308-0520 | 2017-01-24 |
| 1265885396 | Painmed LLC | Pain Medicine | 7337 E Thomas Rd, Scottsdale, AZ 85251-7215 | 2016-07-13 |
| 1609264837 | Integrative Pain Centres of Prescott | Pain Medicine | 3769 Crossings Drive, Suite B, Integrative Pain Centres of Prescott, Prescott, AZ 86305 | 2014-12-22 |
| 1780943456 | Desert Rose Neurology | Pain Medicine | 2480 E Wilcox Dr, Sierra Vista, AZ 85635-2841 | 2012-05-15 |
| 1356614176 | Allen Family Medicine Pllc | Pain Medicine | 7233 E Baseline Rd, Ste 126, Mesa, AZ 85209-5007 | 2012-02-10 |
| 1467730135 | Jose M. Chavez | Pain Medicine | 1704 W Anklam Rd Ste 108, Tucson, AZ 85745-2656 | 2011-07-29 |
| 1396034625 | Arizona Pain Center LLC | Pain Medicine | 8787 E Mountain View Rd, Unit 1025, Scottsdale, AZ 85258-1452 | 2011-04-07 |
| Find all providers with the same taxonomy | ||||
| City | FORT MOHAVE |
| Zip Code | 86426 |
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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.