Provider Demographics
NPI:1740528637
Name:CRIMSON PAIN MANAGEMENT, LLC
Entity type:Organization
Organization Name:CRIMSON PAIN MANAGEMENT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:KLOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-302-1437
Mailing Address - Street 1:7100 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1862
Mailing Address - Country:US
Mailing Address - Phone:913-242-7570
Mailing Address - Fax:913-242-7572
Practice Address - Street 1:5701 W. 119TH ST STE 102
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209
Practice Address - Country:US
Practice Address - Phone:913-498-6124
Practice Address - Fax:913-498-6117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-28
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS7905560001OtherDME
MOMA4438Medicare PIN