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General NPI Number Information
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NPI Number | 1114553229
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Entity Type | Organization
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Legal Business Name | PAIN GPS CLINIC, LLC
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Dates
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Enumeration Date | 03/20/2020
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 1605 OAK ST
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City | EUGENE
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State | OR
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Zip | 97401-4022
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Country | US
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Telephone | 541-246-3400
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Fax | 541-246-3421
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Provider Business Mailing Address
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Address Line | 2852 WILLAMETTE ST STE 400
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City | EUGENE
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State | OR
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Zip | 97405-8200
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Country | US
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Telephone | 541-246-3400
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | JEREMY SCOTT JOHNSTON
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Credential |
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Telephone | 702-339-8602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0000X
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Taxonomy Name | Pain Management Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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