1. Home
  2. Directory
  3. Michigan
  4. Saint Joseph
  5. Pain Medicine
  6. NPI Profile

MICHIANA SPINE, SPORTS & OCCUPATIONAL REHAB, PC
NPI 1407115884
Pain Medicine - Interventional Pain Medicine in Saint Joseph, MI

Active since May 07, 2012CLIA 23D1104688 · Accreditation
2500 NILES RD STE 3, SAINT JOSEPH, MI 49085(574) 252-4150(574) 252-4159 Get Directions Write a Review

NPPES record last updated: November 3, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 3, 2022, Oct 24, 2022 (2 updates tracked since 2022).

About Michiana Spine, Sports & Occupational Rehab, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHIANA SPINE, SPORTS & OCCUPATIONAL REHAB, PC (NPI 1407115884) is a healthcare organization registered as an interventional pain medicine in Saint Joseph, Michigan and active in the NPI registry since May 2012. The organization holds an CLIA Accreditation certificate valid through February 25, 2028 and lists Kevin G Drew, Owner, as its authorized official.

NPPES Registry Identity

NPI1407115884
Entity TypeOrganization
Primary Taxonomy208VP0014X
Legal Business NameMICHIANA SPINE, SPORTS & OCCUPATIONAL REHAB, PC
Location Address2500 NILES RD STE 3Saint Joseph, MI 49085-3225
Mailing Address3740 Edison Lakes PkwyMishawaka, IN 46545-3474 · (574) 252-4150 · Fax (574) 252-4159
Phone(574) 252-4150
Fax(574) 252-4159
Organization SubpartNo
Authorized OfficialKevin G DrewOwner · (574) 252-4150
Enumeration DateMay 7, 2012
Last NPPES UpdateNovember 3, 20222 updates tracked since enumeration
NPPES CertifiedNovember 3, 2022
✔ NPI 1407115884 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0014X
License✔ Licensed in MI · 4301070312
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.
2500 NILES RD STE 3, Saint Joseph, MI 49085
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 23D1104688

Michiana Spine Sports & Occupational Rehab PC · St Joseph, MI
Active · expires Feb 25, 2028
CLIA Number23D1104688
Laboratory TypePhysician Office
Certificate Effective DateFebruary 26, 2026
Certificate Expiration DateFebruary 25, 2028
Laboratory DirectorJacqueline Hurt
Laboratory Phone(269) 428-1550
Laboratory LocationMichiana Spine Sports & Occupational Rehab PC2946 Division Street, St Joseph, MI 49085
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michiana Spine, Sports & Occupational Rehab, PC's NPI number?

The NPI number for Michiana Spine, Sports & Occupational Rehab, PC is 1407115884. It was assigned to this organization in the NPPES registry on May 7, 2012.

Where is Michiana Spine, Sports & Occupational Rehab, PC located?

Michiana Spine, Sports & Occupational Rehab, PC is located at 2500 Niles Rd Ste 3, Saint Joseph, MI 49085. The listed phone number is (574) 252-4150.

What is Michiana Spine, Sports & Occupational Rehab, PC's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Does Michiana Spine, Sports & Occupational Rehab, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 23D1104688) is associated with this NPI, valid through February 25, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Michiana Spine, Sports & Occupational Rehab, PC was last updated on November 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.