SOUTHWEST SPINE AND PAIN CARE SPECIALISTS, LLC


Address: 301 N 200 E Ste 2a, St George, UT 84770-3040
Phone: 4356887246

SOUTHWEST SPINE AND PAIN CARE SPECIALISTS, LLC (NPI# 1891320644) 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) 1891320644
Entity Type Organization
Organization Name SOUTHWEST SPINE AND PAIN CARE SPECIALISTS, LLC
Practice Address 301 N 200 E Ste 2a
St George
UT 84770-3040
Mailing Address 652 S Medical Center Dr Ste 110
St George
UT 84790-7077
Practice Telephone 4356887246
Practice Fax Number 4356881363
Mailing Telephone 4352150230
Mailing Fax Number 4359867092
Enumeration Date 2020-03-11
Last Update Date 2020-03-11
Authorized Official Name DEREK LEE FRIEDEN (MANAGING PARTNER)
Authorized Official Telephone 4356562424
Is Organization Subpart Y
Parent Organization Name SOUTHWEST SPINE AND PAIN CARE SPECIALISTS, LLC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 111N00000X Chiropractor Chiropractic Providers
N 111NS0005X Chiropractor
Specialization: Sports Physician
Chiropractic Providers
N 225100000X Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Y 207LP2900X Anesthesiology
Specialization: Pain Medicine
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Southwest Spine and Pain Center Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1003441858 Southwest Spine and Pain Care Specialists, LLC Clinical Medical Laboratory 2051 E Red Hills Pkwy Ste 7, St George, UT 84770-8671 2020-03-11

Office Location

Street Address 301 N 200 E STE 2A
City ST GEORGE
State UT
Zip Code 84770-3040

Providers in the same location

NPI Name Taxonomy Address Enumeration
1932430782 Russell D. Jepson Chiropractor 301 N 200 E Ste 2a, St George, UT 84770-3040 2010-01-19
1407159130 Brian Dwayne Lefler Physician Assistant 301 N 200 E Ste 2a, St George, UT 84770-3040 2010-12-20
1447571385 Stacie L Oliver Anesthesiology 301 N 200 E Ste 2a, St George, UT 84770-3040 2010-06-15

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1740808500 Redstone Reference Laboratories Inc Clinical Medical Laboratory 556 N Dixie Drive, Suite 2, St George, UT 84770 2020-07-08
1033776315 Ecko Ashmore Marriage & Family Therapist 1173 S. 250 W. Bld 1 Ste 208, St. George, UT 84770 2019-05-22
1740844679 Amy Darragh Behavior Technician 249 E Tabernacle St, Ste 100, St George, UT 84770 2019-04-25
1124598198 Loren Kyle Gulbranson Internal Medicine Dixie Regional Medical Center, 515 South, 300 East, Saint George, UT 84770 2018-12-03
1487150728 Sound Sleep Medical LLC Durable Medical Equipment & Medical Supplies 640 East 700 South Building 2, St. George, UT 84770 2018-04-04
1588162911 Desert Edge Medical Family Medicine 1664 S Dixie Dr Ste D201, St George, UT 84770 2018-01-31
1568981314 Jeffrey Joseph Peterson Behavior Technician 162 N 400 E Ste A-105, St. George, UT 84770 2017-09-13
1992242549 Zachary Carey Specialist/Technologist 1115 W Diamond Valley Dr, Saint George, UT 84770 2017-01-20
1669920427 Charles Taylor Church Technician, Other 474 West 200 East, St. George, UT 84770 2016-09-21
1952755480 Hollystic Hideaway Voluntary or Charitable 1418 W Sunset Blvd. # 2, Saint George, UT 84770 2016-04-21
Find all providers in zip 84770

Taxonomy Information

Taxonomy Code 207LP2900X
Grouping Allopathic & Osteopathic Physicians
Classification Anesthesiology
Specialization Pain Medicine

Taxonomy Definition

An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1205058294 Joseph Courtney Empey Anesthesiology 617 E Riverside Dr Ste 301, St George, UT 84790-8722 2007-05-02
1164421053 Dale Gerald Stott Anesthesiology 301 N 200 E, Suite 2a, St George, UT 84770-3010 2005-07-21
1447571385 Stacie L Oliver Anesthesiology 301 N 200 E Ste 2a, St George, UT 84770-3040 2010-06-15
1043473358 David A Debenham Md PC Anesthesiology 620 S 400 E, Suite 201, St George, UT 84770-3700 2008-07-07
1831359298 Dale G Stott Md PC Anesthesiology 301 N 200 E, Suite 2a, St George, UT 84770-3010 2008-06-10
1659559367 Anesthesia Consultants LLC Anesthesiology 640 E 700 S Ste 10b, St George, UT 84770-4036 2008-02-05
1356444863 St George Surgical Center Lp Anesthesiology 676 S Bluff St, St George, UT 84770-3596 2006-09-07
1205814803 Jon B Obray Anesthesiology 652 S Medical Center Dr, Ste. 110, St George, UT 84790-7049 2006-01-04
1528059201 Derek Lee Frieden Anesthesiology 652 S Medical Center Dr, Ste 110, St George, UT 84790-7017 2005-11-02

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1952865412 Avail Medical LLC Anesthesiology 5742 S 1475 E Ste 200, South Ogden, UT 84403-4856 2019-01-29
1033597257 Ashley Renee Donaldson Anesthesiology Spinal Interventions, 280 W River Park Drive Suite 200, Provo, UT 84604 2015-05-07
1609204338 Interventional Spine & Pain Management Anesthesiology 5801 S Fashion Blvd Ste 180, Murray, UT 84107-8135 2013-10-15
1225387491 Clinton D. Olsen Anesthesiology 280 W River Park Dr, Suite 200, Provo, UT 84604-5793 2012-09-04
1134429384 Intermountain Medical Monitoring LLC Anesthesiology 1306 Deer Crest, Fruit Heights, UT 84037 2010-10-21
1861622219 Jeremy Joyal Anesthesiology 11760 S 700 E Ste 112, Draper, UT 84020-6605 2009-07-20
1962439570 Gordon Petty George, Md, PC Anesthesiology 800 N 700 W, Ste 340a, Orem, UT 84057 2006-06-27
1770558090 Bryan C Hoelzer Anesthesiology 320 River Park Dr Ste 255, Provo, UT 84604 2006-02-21
1437627080 Advanced Spine and Pain Pllc Anesthesiology 11760 S 700 E Ste 112, Draper, UT 84020-6605 2018-11-12
1508216680 Rayhan A. Tariq Anesthesiology 30 N 1900 E Rm 3c444, Salt Lake City, UT 84132-0002 2016-06-20
Find all providers with the same taxonomy

Competitor

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City ST GEORGE
Zip Code 84770

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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