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Interventional Spine and Pain Institute LLC

Interventional Pain Medicine Physician in Melbourne, FL · enumerated 2025 · authorized official Phaedra Shudra, Credentialing and Contracting Speci.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1093695504

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Registry record

Entity type Organization (Type 2)
Legal business name Interventional Spine and Pain Institute LLC
Practice address 6559 N Wickham Rd, Melbourne, FL, 32940
Phone (772) 360-1997
Fax (772) 492-3541
Enumeration date Sep 4, 2025
Last updated in NPPES Sep 26, 2025

Taxonomy & classification

207L00000X Anesthesiology Physician Allopathic & Osteopathic Physicians Secondary
207LP2900X Pain Medicine (Anesthesiology) Physician Allopathic & Osteopathic Physicians Secondary
207RH0002X Hospice and Palliative Medicine (Internal Medicine) Physician Allopathic & Osteopathic Physicians Secondary
208100000X Physical Medicine & Rehabilitation Physician Allopathic & Osteopathic Physicians Secondary
208VP0000X Pain Medicine Physician Allopathic & Osteopathic Physicians Secondary
208VP0014X Interventional Pain Medicine Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Phaedra Shudra
Title Credentialing and Contracting Speci
Phone (813) 785-4861

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Interventional Spine and Pain Institute LLC?
The NPI for Interventional Spine and Pain Institute LLC is 1093695504, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Interventional Spine and Pain Institute LLC?
NPPES lists Phaedra Shudra (Credentialing and Contracting Speci) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-09-26.