INTERVENTIONAL PAIN SERVICE LLC (NPI# 1689681793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689681793 |
| Entity Type | Organization |
| Organization Name | INTERVENTIONAL PAIN SERVICE LLC |
| Practice Address |
201 N Clyde Morris Blvd Suite 120 Daytona Beach FL 32114-2724 |
| Practice Telephone | 3862544029 |
| Practice Fax Number | 3862544274 |
| Mailing Telephone | 3862544029 |
| Mailing Fax Number | 3862544274 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. WILLIAM ROSS MAYFIELD (MEMBER MANAGER) |
| Authorized Official Telephone | 3862544029 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
ME0063660 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE SHIELD | 18828 | 01 |
| Street Address |
201 N CLYDE MORRIS BLVD SUITE 120 |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-2724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891791380 | Sharon Noble Goldish | Surgery | 201 N Clyde Morris Blvd, Ste 205, Daytona Beach, FL 32114-2724 | 2005-06-21 |
| 1346866332 | Hedson Ricardo Desir | Family Medicine | 201 N Clyde Morris Blvd, Daytona Beach, FL 32114-2724 | 2020-06-25 |
| 1215596143 | Rik Jozef Spelmans | Physical Therapist | 201 N Clyde Morris Blvd, Daytona Beach, FL 32114-2724 | 2019-06-13 |
| 1891220489 | Kirstin Labell | Family Medicine | 201 N Clyde Morris Blvd, Daytona Beach, FL 32114-2724 | 2017-04-20 |
| 1619401635 | Michael Faille | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Daytona Beach, FL 32114-2724 | 2017-04-17 |
| 1104359900 | Kirk Andrew Denning | Occupational Therapist | 201 N Clyde Morris Blvd, Suite 300, Daytona Beach, FL 32114-2724 | 2017-04-07 |
| 1871030080 | Nancy Quist | Social Worker | 201 N Clyde Morris Blvd, Suite 210, Daytona Beach, FL 32114-2724 | 2017-01-25 |
| 1558816405 | Patricia Kurty | Community Health Worker | 201 N Clyde Morris Blvd, Daytona Beach, FL 32114-2724 | 2016-08-22 |
| 1780035956 | Heather Clark | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Daytona Beach, FL 32114-2724 | 2016-06-28 |
| 1689025009 | Suresh Kandavanam | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Daytona Beach, FL 32114-2724 | 2016-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| 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 |
|---|---|---|---|---|
| 1841618782 | Richard C. Sims | Pain Medicine | 1075 Mason Ave, Daytona Beach, FL 32117-4611 | 2014-03-28 |
| 1578627568 | William Ross Mayfield | Pain Medicine | 201 N Clyde Morris Blvd, Suite 120, Daytona Beach, FL 32114-2724 | 2006-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659979706 | Specialty Physician Services. LLC | Pain Medicine | 9150 Sw 87th Ave Ste 200, Miami, FL 33176-2313 | 2020-10-12 |
| 1700403847 | Advanced Interventional Pain Center Fl | Pain Medicine | 1831 N Belcher Rd Ste E1, Clearwater, FL 33765-1442 | 2020-07-05 |
| 1770108110 | The Neomedicine Institute LLC | Pain Medicine | 2510 Nw 97th Ave Ste 110, Doral, FL 33172-1407 | 2020-06-11 |
| 1316583362 | Lisa M Gonzalez | Pain Medicine | 8136 Centralia Ct Ste 103, Leesburg, FL 34788-3757 | 2019-11-25 |
| 1306488820 | Alberto Rivera-sanchez Pa | Pain Medicine | 201 W Canton Ave Ste 275, Winter Park, FL 32789-3148 | 2019-10-16 |
| 1912560798 | Jacksonville Spine Center Pa | Pain Medicine | 2349 Village Square Pkwy Ste 107, Fleming Island, FL 32003-4319 | 2019-04-17 |
| 1942765144 | Nixpain LLC | Pain Medicine | 2750 Ne 14th St, Fort Lauderdale, FL 33304-1611 | 2019-02-01 |
| 1346737749 | Ceda Orthopedics Group, LLC. | Pain Medicine | 815 Nw 57th Avenue, Ste. 202, Miami, FL 33126 | 2018-04-20 |
| 1174025001 | Lighthouse Point Surgery Center LLC | Pain Medicine | 1821 Ne 25th St Ste 100, Lighthouse Point, FL 33064-7744 | 2018-03-07 |
| 1801394440 | Neuspine Therapy LLC | Pain Medicine | 12880 Us 301, Dade City, FL 33525-5801 | 2018-01-29 |
| Find all providers with the same taxonomy | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
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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.