Provider Demographics
NPI:1730189622
Name:CINCINNATI PAIN MANAGEMENT CONSULTANTS LTD
Entity type:Organization
Organization Name:CINCINNATI PAIN MANAGEMENT CONSULTANTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:WELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-865-5204
Mailing Address - Street 1:9000 W. 67TH STREET
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66020-3656
Mailing Address - Country:US
Mailing Address - Phone:888-562-5589
Mailing Address - Fax:913-262-3633
Practice Address - Street 1:8261 CORNELL RD STE 630
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-2279
Practice Address - Country:US
Practice Address - Phone:513-891-0022
Practice Address - Fax:513-891-5681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0997999Medicaid
IN200001000Medicaid
KY65945776Medicaid
OHCI9935401Medicare PIN