Healthcare Provider Details

I. General information

NPI: 1013018076
Provider Name (Legal Business Name): PAIN SOURCE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 CLAY EDWARDS DR
NORTH KANSAS CITY MO
64116-3220
US

IV. Provider business mailing address

PO BOX 411099
KANSAS CITY MO
64141-1099
US

V. Phone/Fax

Practice location:
  • Phone: 816-221-4114
  • Fax: 816-471-1247
Mailing address:
  • Phone: 816-221-5050
  • Fax: 816-471-1247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: SEAN CLINEFELTER
Title or Position: PROVIDER AUTHORIZED OFFICIAL
Credential: MD
Phone: 816-221-5050