Pain Center of Virginia, PLLC

Primary specialty

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

License

25285 Issued in WV

Legal business name

PAIN CENTER OF VIRGINIA, PLLC

Practice address

1839 West Plaza Drive
Winchester, VA 22601

Phone

(540) 773-2689

Fax

(540) 486-4166

NPI assigned

May 2, 2017

Organization subpart

No

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

Authorized official

Name

Amanda Larrick

Title

Practice Coordinator

Phone

(304) 263-6165

Specialties & licenses 1

Addresses

Other names 1

• Pain Center of West Virginia Other name

Medicare fee-for-service enrollment

Enrolled in VA, WV, MD4 enrollments

Enrollment records 4

Locations

Practitioners 3

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

• Waheed S Baksh, MD, DPT

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Winchester, VA
  • NPI 1033393871

  MD, WV

  Medicare reassignment Care Compare group NPD
• Kristen Nicole Williams, PA-C

  • Medical Physician Assistant
  • Winchester, VA
  • NPI 1659835072

  MD, WV

  Medicare reassignment Care Compare group
• Aimee Noel Staley, PSYD

  • Clinical Neuropsychologist
  • Columbus, GA
  • NPI 1063451847
  NPD (past)

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614211200000",
    "number": "1144756768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 TAVERN RD",
            "address_2": "SUITE 300",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012845",
            "telephone_number": "304-263-6165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 WEST PLAZA DRIVE",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "22601",
            "telephone_number": "540-773-2689",
            "fax_number": "540-486-4166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Tavern Rd",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "WV",
            "postal_code": "254012845",
            "country_code": "US",
            "telephone_number": "304-263-6165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PAIN CENTER OF VIRGINIA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-02",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A",
        "authorized_official_last_name": "LARRICK",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "PRACTICE COORDINATOR",
        "authorized_official_telephone_number": "304-263-6165"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "WV",
            "license": "25285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain Center of West Virginia",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Pain Center of West Virginia",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Illa Jane Owens
• Jessica Owens
• Justin Eserovwe Owumi
• Erin Pahl
• Pain Center of Virginia PLLC (Meridian Physical Therapy)
• Pain Center of Virginia, PLLC
• Pain Specialists of Winchester, Inc.
• Katlyn Painter
• Sydney Lauren Painter, BEHAVIOR TECHNICIAN
• Pamela Gayatinea Palma, MD

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Winchester, VA
• Providers in Winchester, VA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.