| Nexus Pain Care | |
|
3585 N University Ave Ste 150 Provo UT 84604-6630 | |
| (801) 356-6100 | |
| (801) 356-2113 |
| Full Name | Nexus Pain Care |
|---|---|
| Speciality | Pain Medicine |
| Location | 3585 N University Ave Ste 150, Provo, Utah |
| Authorized Official Name and Position | Richard M Rosenthal (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8013566100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nexus Pain Care 3585 N University Ave Ste 150 Provo UT 84604-6630 Ph: (801) 356-6100 | Nexus Pain Care 3585 N University Ave Ste 150 Provo UT 84604-6630 Ph: (801) 356-6100 |
| NPI Number | 1902805948 |
|---|---|
| Provider Enumeration Date | 07/20/2005 |
| Last Update Date | 09/30/2014 |
| Medicare PECOS PAC ID | 4587560693 |
|---|---|
| Medicare Enrollment ID | O20031210000117 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902805948 | NPI | - | NPPES |
| Provider Name | Richard M Rosenthal |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1073512745 PECOS PAC ID: 3476459595 Enrollment ID: I20031210000298 |
| Provider Name | Brian Kenneth Olenslager |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1225036064 PECOS PAC ID: 0840262226 Enrollment ID: I20040806000702 |
| Provider Name | James Henry Cloyd |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750450953 PECOS PAC ID: 7911907001 Enrollment ID: I20070115000351 |
| Provider Name | Tao Li |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1376725143 PECOS PAC ID: 4880765049 Enrollment ID: I20080616000139 |
| Provider Name | Robert James Kinne |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1265870588 PECOS PAC ID: 1355645391 Enrollment ID: I20170522002469 |
| Provider Name | Diane Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508250580 PECOS PAC ID: 4385965029 Enrollment ID: I20180731002395 |
| Provider Name | Jason Jon Nakken |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1356755094 PECOS PAC ID: 9638410590 Enrollment ID: I20190531000971 |
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