PACIFIC SPORTS AND INTERVENTIONAL SPINE, LLC


Address: 74b Centennial Loop Ste 100, Eugene, OR 97401-7919
Phone: 5416863791

PACIFIC SPORTS AND INTERVENTIONAL SPINE, LLC (NPI# 1881186336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881186336
Entity Type Organization
Organization Name PACIFIC SPORTS AND INTERVENTIONAL SPINE, LLC
Other Organization Name PACIFIC SPORTS AND SPINE
Practice Address 74b Centennial Loop Ste 100
Eugene
OR 97401-7919
Practice Telephone 5416863791
Practice Fax Number 5416863795
Mailing Telephone 5416863791
Mailing Fax Number 5416863795
Enumeration Date 2018-05-31
Last Update Date 2018-11-29
Authorized Official Name SAM DERRICK (ADMINISTRATOR)
Authorized Official Telephone 5416863791
Authorized Official Credential MHA, CMPE
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 208VP0014X Pain Medicine
Specialization: Interventional Pain Medicine
MD28629 OR Allopathic & Osteopathic Physicians
N 363A00000X Physician Assistant PA00800 OR Physician Assistants & Advanced Practice Nursing Providers
N 363A00000X Physician Assistant PA00420 OR Physician Assistants & Advanced Practice Nursing Providers
N 363A00000X Physician Assistant PA152998 OR Physician Assistants & Advanced Practice Nursing Providers
Y 208VP0014X Pain Medicine
Specialization: Interventional Pain Medicine
MD27887 OR Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
OR 500624453 05
OR 244117 05
OR 500608609 05
OR 500632183 05
OR 500604467 05

Other Provider/Organization Names

Other Name Type Code
Pacific Sports and Spine Doing Business As Name - Organization

Office Location

Street Address 74B CENTENNIAL LOOP STE 100
City EUGENE
State OR
Zip Code 97401-7919

Providers in the same location

NPI Name Taxonomy Address Enumeration
1831125616 Joseph S Dunn Pain Medicine 74b Centennial Loop Ste 100, Eugene, OR 97401-7919 2006-06-24
1023594801 Neurospine Group Neurological Surgery 74b Centennial Loop Ste 100, Eugene, OR 97401-7919 2018-07-16
1730575119 Rishi Vora Physical Medicine & Rehabilitation 74b Centennial Loop Ste 100, Eugene, OR 97401 2015-04-12
1902000599 Carmina Flores Angeles Neurological Surgery 74b Centennial Loop Ste 100, Eugene, OR 97401-7919 2007-06-14
1982612446 Stephen G. Giles Physician Assistant 74b Centennial Loop Ste 100, Eugene, OR 97401 2006-08-03
1679594089 Dana Kathryn Rubin Physician Assistant 74b Centennial Loop Ste 100, Eugene, OR 97401-7919 2006-07-21

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1427681709 Sarah Voigt Counselor 2149 Centennial Plaza Suite #4, Eugene, OR 97401 2020-02-14
1801426242 Therapeutic Associates, Inc. Physical Therapist 760 Charnelton St., Suite 760, Eugene, OR 97401 2020-01-24
1225676232 Aaron James Barber Massage Therapist 1375 Pearl St, Eugene, Or 97401, Eugene, OR 97401 2019-12-20
1851957047 Altru Home Care LLC Nursing Care 1345 Olive St., Eugene, OR 97401 2019-05-14
1881155208 Herron Jordanna Spence Speech-Language Pathologist 385 West 2nd Ave., Eugene, OR 97401 2019-03-28
1750855094 Brandon Marshall Counselor 1158 High St Ste 202, Eugene, OR 97401 2019-01-21
1881172591 Kayla Nicole O'brien Nurse Practitioner Country Club In Eugene, 520 Country Club Road, Eugene, OR 97401 2018-08-03
1962992180 Shannon Jensen Smyth Counselor Va Eugene Downtown Clinic, 211 E. 7th Ave, Eugene, OR 97401 2018-05-14
1902305956 Christine Noel Gray Peer Specialist 499 W. 4th Ave, Eugene, OR 97401 2018-02-06
1821507344 Anjuli Chitkara Psychologist 1679 Willamette Street, Eugene, OR 97401 2017-09-27
Find all providers in zip 97401

Taxonomy Information

Taxonomy Code 208VP0014X
Grouping Allopathic & Osteopathic Physicians
Classification Pain Medicine
Specialization Interventional Pain Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1831125616 Joseph S Dunn Pain Medicine 74b Centennial Loop Ste 100, Eugene, OR 97401-7919 2006-06-24
1235319666 Michael Karasek, Md,pc Pain Medicine 689 E 19th Ave, Eugene, OR 97401-4304 2007-11-14
1457496705 Gregory Anthony Moore Pain Medicine 74b Centennial Loop, Suite 100, Eugene, OR 97401-7918 2007-02-21
1366500589 Pain Consultants of Oregon PC Pain Medicine 360 S Garden Way Ste 101, Eugene, OR 97401-8034 2006-12-04
1184649303 Donna M Morgan Pain Medicine 1125 Darlene Ln, Suite 200, Eugene, OR 97401-1601 2006-07-12

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1164942611 Mid-valley Healthcare, Inc. Pain Medicine 5234 Sw Philomath Blvd Ste C, Corvallis, OR 97333-1042 2017-06-26
1093269995 Center for Regenerative Orthopedic Medicine, PC Pain Medicine 786 State St, Medford, OR 97504-8441 2016-08-09
1649420548 Pacific Pain Management PC Pain Medicine 6542 Se Lake Rd Ste 202, Milwaukie, OR 97222-2245 2008-09-26
1336265107 Laura M Scobie Pain Medicine 1010 Tenth St, Hood River, OR 97031 2007-03-22
1427188309 Patrick Rask Pain Medicine 2364 Main St, Suite A, Philomath, OR 97370-9488 2007-03-07
1912940396 Mid-valley Healthcare Inc Pain Medicine 100 Mullins Dr Ste C, Lebanon, OR 97355-3982 2006-06-14
1063418333 Vladimir B. Fiks Pain Medicine 10305 Sw Park Way, Ste 300, Portland, OR 97225-5033 2005-06-22
1861900516 Cornell Pain Clinic LLC Pain Medicine 15455 Nw Greenbrier Pkwy Ste 130, Beaverton, OR 97006 2018-01-16
1578077954 Liberty Spine & Pain Center, P.C. Pain Medicine 350 Miller St Se, Salem, OR 97302-4272 2017-11-21
1003362922 Mid-valley Healthcare, Inc. Pain Medicine 100 Mullins Dr Ste C1, Lebanon, OR 97355-2868 2016-08-31
Find all providers with the same taxonomy

Competitor

Search similar providers

City EUGENE
Zip Code 97401

Improve Information

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Dataset Information

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.

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