CMS-1500 Box 24J / 33a • NPI
1821014580
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
208VP0014X (CMS 09)
Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Interventional Pain Medicine
Box 32 Service Location & ZIP+4
613 W LINCOLN RD STE A, KOKOMO, IN, 46902-3460
✓ 9-Digit EDI 837 ZIP+4 (46902-3460)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1821014580 (ADVANCED INTERVENTIONAL PAIN CENTER LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1821014580 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ADVANCED INTERVENTIONAL PAIN CENTER LLC |
| Plain-English Specialty | Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Interventional Pain Medicine NUCC Code: 208VP0014X (Pain Medicine, Interventional Pain Medicine) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 613 W LINCOLN RD STE A, KOKOMO, IN, 46902-3460 |
| Practice Telephone / Fax | Tel: (765) 319-3522 | Fax: (765) 450-6161 |
| Administrative Mailing Address | 2001 N GRANVILLE AVE, MUNCIE, IN, 47303-2110 |
| Enumeration & Last Sync | Enumerated: 2006-07-14 | CMS Record Updated: 2020-07-04 |
| Authorized Official | PATTANAM SRINIVASAN (CEO) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (208VP0014X)
What Does Taxonomy Code 208VP0014X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208VP0014X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Interventional Pain Medicine"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ADVANCED INTERVENTIONAL PAIN CENTER LLC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
208VP0014X — Pain Medicine, Interventional Pain MedicinePlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Interventional Pain Medicine | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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