NPIMap

Organization Active NPI

Choice Pain & Rehabilitation Center

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Milford, DE
National Provider Identifier
1134815970
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
CHOICE PAIN & REHABILITATION CENTER
Practice address
550 S Dupont Blvd Ste C
Milford, DE 19963-1704
Phone
(302) 330-5051
NPI assigned
Apr 14, 2023
Last updated
Apr 14, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CHOICE PAIN & REHABILITATION CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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

Authorized official

Name
Tristan Shockley, MDNPI 1932242542
Title
Ceo
Phone
(224) 347-4875

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: 193200000X MULTI-SPECIALTY GROUP 2081P2900X Primary

Addresses

Primary practice location

550 S Dupont Blvd Ste C
Milford, DE 19963-1704

Mailing address

8843 Greenbelt Rd Ste 117
Greenbelt, MD 20770-2451
Phone (240) 786-1001

National Provider Directory

National Provider Directory
Tax ID family
Choice Pain Rehabilitation Center7 organizations share this tax ID, including this one
Part of
Choice Pain Rehabilitation Center

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681430400000",
    "number": "1134815970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8843 GREENBELT RD STE 117",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207702451",
            "telephone_number": "240-786-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S DUPONT BLVD STE C",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199631704",
            "telephone_number": "302-330-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOICE PAIN & REHABILITATION CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHOICE PAIN & REHABILITATION CENTER",
        "enumeration_date": "2023-04-14",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A",
        "authorized_official_last_name": "SHOCKLEY",
        "authorized_official_first_name": "TRISTAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "224-347-4875",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.