Healthcare Provider Details

I. General information

NPI: 1740528637
Provider Name (Legal Business Name): CRIMSON PAIN MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2013
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 W. 119TH ST STE 102
OVERLAND PARK KS
66209
US

IV. Provider business mailing address

5401 COLLEGE BLVD STE 111
LEAWOOD KS
66211-1626
US

V. Phone/Fax

Practice location:
  • Phone: 913-498-6124
  • Fax: 913-498-6117
Mailing address:
  • Phone: 913-242-7570
  • Fax: 913-242-7572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MISS DONTAY ROSS
Title or Position: OFFICE MANAGER
Credential:
Phone: 913-242-7570