CORYDON PAIN MANAGEMENT CLINIC INC. (NPI# 1689966434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689966434 |
| Entity Type | Organization |
| Organization Name | CORYDON PAIN MANAGEMENT CLINIC INC. |
| Practice Address |
2230 Edsel Ln Nw Ste 1 Corydon IN 47112-2136 |
| Mailing Address |
Po Box 221273 Louisville KY 40252-1273 |
| Practice Telephone | 8127340303 |
| Practice Fax Number | 8122255145 |
| Mailing Telephone | 8127340303 |
| Mailing Fax Number | 8122255145 |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2020-07-17 |
| Authorized Official Name | RENEE TORNATORE (OWNER) |
| Authorized Official Telephone | 8127340303 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 111N00000X | Chiropractor | Chiropractic Providers | ||
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 332900000X | Non-Pharmacy Dispensing Site | Suppliers | ||
| N | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201058650A | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2086 Old Highway 135 Nw Ste 1, Corydon, IN 471124015 | 8127340303 | 8122255145 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | CORYDON PAIN MANAGEMENT CLINIC INC. | 2086 Old Hwy 135nw - Ste 2, Corydon, IN 47112 |
| Street Address |
2230 EDSEL LN NW STE 1 |
| City | CORYDON |
| State | IN |
| Zip Code | 47112-2136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669479937 | Anthony R Sehlinger | Anesthesiology | 2230 Edsel Ln Nw Ste 1, Corydon, IN 47112-2136 | 2005-07-01 |
| 1033734173 | Amy Lee Delk | Pain Medicine | 2230 Edsel Ln Nw Ste 1, Corydon, IN 47112-2136 | 2020-06-15 |
| 1720612096 | Olivia Paige Beam | Pain Medicine | 2230 Edsel Ln Nw Ste 1, Corydon, IN 47112-2136 | 2020-02-26 |
| 1114588506 | Katherine Nicole Smith | Nurse Practitioner | 2230 Edsel Ln Nw Ste 1, Corydon, IN 47112-2136 | 2019-06-26 |
| 1144790296 | Courtney Monique Tutt | Nurse Practitioner | 2230 Edsel Ln Nw Ste 1, Corydon, IN 47112-2136 | 2018-12-03 |
| 1861961062 | Alysen Renee Adams | Physician Assistant | 2230 Edsel Ln Nw Ste 1, Corydon, IN 47112-2136 | 2018-11-16 |
| 1710375001 | Christina J Bean | Pain Medicine | 2230 Edsel Ln Nw Ste 1, Corydon, IN 47112-2136 | 2015-01-08 |
| 1356615975 | Derek Richard Jordan | Chiropractor | 2230 Edsel Ln Nw Ste 1, Corydon, IN 47112-2136 | 2012-02-29 |
| 1447574371 | Chad M Galle | Pain Medicine | 2230 Edsel Ln Nw Ste 1, Corydon, IN 47112-2136 | 2010-03-22 |
| 1710023957 | Renee A Tornatore | Chiropractor | 2230 Edsel Ln Nw Ste 1, Corydon, IN 47112-2136 | 2007-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467073544 | Frances M Lasley | Massage Therapist | 1300 N Old Hwy 135, Ste 3, Corydon, IN 47112 | 2020-04-30 |
| 1730744525 | Elizabeth Walden-fisher | Social Worker | Lifespring Health Systems, 535 Country Club Road, S.e., Corydon, IN 47112 | 2019-05-07 |
| 1770927030 | Hannah Wallace | Speech-Language Pathologist | 1079 Alexis Ave Ne, Corydon, IN 47112 | 2013-04-17 |
| 1346590502 | Rocky Mountain Holdings LLC | Ambulance | 1269 Hospital Dr Nw, Corydon, IN 47112 | 2012-09-14 |
| 1295011294 | Karen Lynn Vannis | Pharmacist | 1716 Hwy 337 Nw, Corydon, IN 47112 | 2011-10-24 |
| 1164710109 | Chris Alan Bezy | Social Worker | 2179 Liberty Way Nw, Corydon, IN 47112 | 2011-07-12 |
| 1902102940 | William Thomas Logsdon Sr. | Hearing Instrument Specialist | 925 Settler Trace, Corydon, IN 47112 | 2011-02-09 |
| 1841507191 | Donna Richmond | Specialist | 150 Beechmont Dr, Harrison Health and Rehabilitation Center, Corydon, IN 47112 | 2010-09-08 |
| 1356670053 | Harrison Township Fire Protection District | Ambulance | 120 Hilltop Dr, Corydon, IN 47112 | 2009-12-09 |
| 1982852083 | Linda Kaufer | Physical Therapy Assistant | 150 Beechmont Drive, Corydon, IN 47112 | 2008-09-03 |
| Find all providers in zip 47112 | ||||
| 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 |
|---|---|---|---|---|
| 1841507191 | Donna Richmond | Specialist | 150 Beechmont Dr, Harrison Health and Rehabilitation Center, Corydon, IN 47112 | 2010-09-08 |
| 1891893376 | Angella Marie Talley | Specialist | 2201 Concord Ave Nw, Ste 100, Corydon, IN 47112-2060 | 2006-09-20 |
| 1922359389 | Stacy Michelle Livers | Specialist | 315 Country Club Rd, Corydon, IN 47112-1751 | 2012-09-26 |
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| 1679078398 | Wright Choice Hairquarters | Specialist | 1815 Fox Point Trl Apt 2, Fort Wayne, IN 46816-2450 | 2018-03-26 |
| 1053819458 | Denise Michelle Strom | Specialist | 8620 Purdue Rd, Indianapolis, IN 46268-1114 | 2018-01-31 |
| 1568995785 | Southlake Internal Medicine LLC | Specialist | 928 Mary Ellen Dr, Crown Point, IN 46307-8998 | 2017-04-05 |
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| 1225581945 | Hossam Eldine Kamal Youssef | Specialist | 7230 Engle Rd Ste 303, Fort Wayne, IN 46804-2227 | 2016-07-28 |
| Find all providers with the same taxonomy | ||||
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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.