Healthcare Provider Details

I. General information

NPI: 1306103932
Provider Name (Legal Business Name): FLINT HILLS PAIN MANAGEMENT PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2012
Last Update Date: 07/03/2023
Certification Date: 07/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 BEECHWOOD TER STE C
MANHATTAN KS
66502-7481
US

IV. Provider business mailing address

1404 BEECHWOOD TER STE C
MANHATTAN KS
66502-7481
US

V. Phone/Fax

Practice location:
  • Phone: 785-320-7576
  • Fax: 785-320-5428
Mailing address:
  • Phone: 785-320-7576
  • Fax: 785-320-5428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THAD A SCHNEIDER
Title or Position: CEO
Credential: DC
Phone: 785-320-7576