Interventional Pain Center, PLLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

DO0000002339 Issued in TN

Legal business name

INTERVENTIONAL PAIN CENTER, PLLC

Doing business as

Interventional Pain Center

Practice address

353 New Shackle Island Rd Ste 148C
Hendersonville, TN 37075-2366

Phone

(615) 972-1100

Fax

(615) 537-4950

NPI assigned

Feb 27, 2017

Last updated

Jan 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Joni Hardwick

Title

Practice Administrator

Phone

(615) 389-7852

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Interventional Pain Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Interventional Pain Center, PLLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Hendersonville, TN
  • NPI 1285976407

  8628217973

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edith Dean, FNP

  • Family Nurse Practitioner
  • Hendersonville, TN
  • NPI 1609218726
  NPD
• Lisa Diaz-Barriga, M.S.N., C.F.N.P.

  • Family Nurse Practitioner
  • Nashville, TN
  • NPI 1104951177
  NPD
• Osayande Abraham Omoregie, PA-C

  • Physician Assistant
  • Nashville, TN
  • NPI 1942605779
  NPD
• Amara Proffitt, NP

  • Nurse Practitioner
  • Hendersonville, TN
  • NPI 1841012879
  NPD
• Robert David Todd, MD

  • Interventional Pain Medicine Physician
  • Hermitage, TN
  • NPI 1811044621
  NPD
• Fairen Walker-McCarter, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Nashville, TN
  • NPI 1942543533
  NPD
• Clayton Robert Walker, PA-C

  • Physician Assistant
  • Hendersonville, TN
  • NPI 1922569565
  NPD
• Brad P Wilson, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Hendersonville, TN
  • NPI 1205002227
  NPD

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1083154819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 NEW SHACKLE ISLAND RD STE 148C",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752366",
            "telephone_number": "615-972-1100",
            "fax_number": "615-537-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 NEW SHACKLE ISLAND RD STE 148C",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752366",
            "telephone_number": "615-972-1100",
            "fax_number": "615-537-4950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3443 Dickerson Pike",
            "address_2": "Suite 730",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372072519",
            "country_code": "US",
            "telephone_number": "615-972-1100",
            "fax_number": "615-537-4950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTERVENTIONAL PAIN CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-27",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A",
        "authorized_official_last_name": "HARDWICK",
        "authorized_official_first_name": "JONI",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "615-389-7852",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "TN",
            "license": "DO0000002339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1531251",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Interventional Pain Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Interventional Pain Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Integrated Care Resources, Inc.
• Interventional Pain Center, PLLC
• Maegan Isbell
• Kendall Jackson, BEHAVIORAL TECH
• Laurie Jackson, LCSW
• Taylor Jacobs

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Hendersonville, TN
• Providers in Hendersonville, TN by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.