Spine and Sports Regenerative Medicine Institute
NPI 1114764107ActiveOrganization· Pain Medicine, Interventional Pain Medicine· Fairfax, VA
Pain Medicine, Interventional Pain Medicine in Fairfax, Virginia, registered in NPPES in July 2024. The authorized official on file is David Kim, MD, Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1114764107 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 9, 2024 |
| Last updated in NPPES | Jul 16, 2024 |
| Certified by provider | Jul 16, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pain Medicine, Interventional Pain Medicine Primary | 208VP0014X | — | — |
| Pain Medicine, Pain Medicine | 208VP0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (DC) |
|---|
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