TRISTATE PAIN AND SPINE CENTER
Complete NPI Record 1861832701
Pain Medicine - Pain Medicine in Mc Murray, PA

NPI Status: Active since June 25, 2013

Contact Information

160 GALLERY DR
STE 200
MC MURRAY, PA
ZIP 15317
Phone: (304) 233-2455

Get Directions

Complete NPI Dataset

This directory record outlines the complete schema field listings, logged data values, and structural definitions for TRISTATE PAIN AND SPINE CENTER (NPI: 1861832701), practicing as a certified pain medicine specialist with primary operations located in Mc Murray, PA. The dataset listed below details the current information logged inside the National Plan and Provider Enumeration System (NPPES) registry database for this specific individual assignment. Please use the integrated filtering tools directly below to separate properties by functional clinical categories, perform live keyword lookups, or jump immediately to a single tracking attribute line item.

Registry File Document Utilities
NPI: 1861832701
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business Name: THREE RIVERS PAIN AND ANESTHESIA ASSOCIATES PLLC
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization Name: TRISTATE PAIN AND SPINE CENTER
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code: 3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: 109 MOUNT WOOD RD
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City Name: WHEELING
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: WV
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 260032632
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider Business Mailing Address Telephone Number: 3042332455
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider First Line Business Practice Location Address: 160 GALLERY DR
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address: STE 200
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: MC MURRAY
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: PA
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 153172690
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 3042332455
The telephone number associated with the location address of the provider being identified.
Authorized Official Last Name: TUNE
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: ADAM
The first name of the authorized official.
Authorized Official Title or Position: OWNER
The title or position of the authorized official.
Authorized Official Telephone Number: 7249414626
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 208VP0000X
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: MD439637
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 1: PA
The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 1: N
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 2: 208VP0000X
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 2: 25058
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 2: WV
The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 2: Y
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Is Organization Subpart: N
Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
Authorized Official Credential Text: MD
The professional credential(s) of the authorized official listed on the provider's NPI record. Examples include MD (Doctor of Medicine), DO (Doctor of Osteopathy), RN (Registered Nurse), DDS (Doctor of Dental Surgery), PhD, or other recognized designations that reflect the official's qualifications.
Healthcare Provider Taxonomy Group 1: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Healthcare Provider Taxonomy Group 2: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
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