MEDICARE: TRI-STATE PAIN MANAGEMENT SERVICE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner
2	208VP0014X	Interventional Pain Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	728014	OTHER	BUCKEYE
2	610168000	OTHER	FEDERAL WORKERS COMP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	5124498	OTHER	CIGNA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013183698
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRI-STATE PAIN MANAGEMENT SERVICE INC

Provider Business Mailing Address
First Line	:	7655 5 MILE RD STE 117
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45230-4326
Country	:	US
Telephone Number	:	513-624-7525
Fax Number	:	513-624-0578

Provider Business Practice Location Address
First Line	:	7520 STATE RD
Second Line	:	MERCY ANDERSON AMBULATORY
City	:	CINCINNATI
State	:	OH
Zip	:	45255-2439
Country	:	US
Telephone Number	:	859-341-7246
Fax Number	:	859-341-7867

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JEWELL ASHLEY
Credential	:
Telephone Number	:	513-624-7525

Provider Enumeration Date	:	05/05/2008
Last Update Date	:	12/15/2020

Similar Medicare Providers

1023000536 — HOSPITALIST SERVICES MEDICAL GROUP OF ANDERSON TOWNSHIP, INC.
Practice Location Address:

7500 STATE RD
CINCINNATI, OH
45255-2439

Practice Phone: 513-624-4500
Practice Fax:

1700870623 — MERCY ANDERSON AMBULATORY SURGERY CENTER
Practice Location Address:

7520 STATE RD
CINCINNATI, OH
45255-2439

Practice Phone: 513-624-1950
Practice Fax: 513-624-1952

1053392654 — LEE STEPHEN MEGOIS MD
Practice Location Address:

7500 STATE RD
CINCINNATI, OH
45255-2439

Practice Phone: 859-341-7246
Practice Fax: 859-341-7867

1134100738 — ALAN ARNOLD GODOFSKY MD
Practice Location Address:

7500 STATE RD , ANESTHESIA INTENSIVE CARE CONSULTANTS INC
CINCINNATI, OH
45255-2439

Practice Phone: 859-341-7246
Practice Fax: 859-341-7867

1588645188 — SOUTHWEST OHIO ANESTHESIA CONSULTANTS LLC
Practice Location Address:

7500 STATE RD
CINCINNATI, OH
45255-2439

Practice Phone: 800-930-6313
Practice Fax: 817-856-0655

1275515470 — MARK CHRISTOPHER ZIEGLER MD
Practice Location Address:

7500 STATE RD , ANESTHESIA INTENSIVE CARE CONSULTANTS INC
CINCINNATI, OH
45255-2439

Practice Phone: 859-341-7246
Practice Fax: 859-341-7867

1053393660 — ROBERT STACY WELLS MD
Practice Location Address:

7500 STATE RD
CINCINNATI, OH
45255-2439

Practice Phone: 859-341-7246
Practice Fax: 859-341-7867

Directions to “TRI-STATE PAIN MANAGEMENT SERVICE INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.