Organization Active NPI

Southern Pain Institute PLLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Murfreesboro, TN
National Provider Identifier
1073855573
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
TN34231 Issued in TN
Legal business name
SOUTHERN PAIN INSTITUTE PLLC
Practice address
1608 Williams Dr Ste 300
Murfreesboro, TN 37129-3195
Phone
(615) 459-3244
NPI assigned
Mar 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anna-Louise Molette, MDNPI 1265455091
Title
Physician
Phone
(615) 459-3244

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X TN34231 TN Primary

Addresses

Primary practice location

1608 Williams Dr Ste 300
Murfreesboro, TN 37129-3195

Mailing address

739 President PL
Suite 220
Smyrna, TN 37167-6844
Phone (615) 459-3244

Other identifiers 1

IdentifierTypeStateIssuer
3736847MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071004000818 TN Part B Supplier - Clinic/Group Practice 8527153568 Receives reassigned benefits from 3 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Murfressboro, TN; Nashville, TN; Smyrna, TN

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Southern Pain Institute PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540857600000",
    "number": "1073855573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 PRESIDENT PL",
            "address_2": "SUITE 220",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676844",
            "telephone_number": "615-459-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 WILLIAMS DR STE 300",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371293195",
            "telephone_number": "615-459-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PAIN INSTITUTE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-22",
        "last_updated": "2018-10-30",
        "status": "A",
        "authorized_official_last_name": "MOLETTE",
        "authorized_official_first_name": "ANNA-LOUISE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "615-459-3244",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "TN",
            "license": "TN34231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3736847",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.