NPIMap

Organization Active NPI

Southern Pain Specialists, P.C.

  • Interventional Pain Medicine Physician
  • Birmingham, AL
National Provider Identifier
1174697106
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
19582 Issued in AL
Legal business name
SOUTHERN PAIN SPECIALISTS, P.C.
Practice address
7191 Cahaba Valley Rd
Suite 204
Birmingham, AL 35242-6402
Phone
(205) 995-9967
Fax
(205) 995-0635
NPI assigned
Nov 20, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Kenneth G Varley, M.D.NPI 1043380900
Title
President
Phone
(205) 995-9967

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

Practitioners 4

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051025000711 AL Part B Supplier - Clinic/Group Practice 9032136429 Receives reassigned benefits from 4 practitioners
Practice locations: Birmingham, AL

National Provider Directory

National Provider Directory

Locations

7191 Cahaba Valley Rd
Ste 200B2
Hoover, AL 35242

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X 491 AL
Interventional Pain Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208VP0014X 19582 AL Primary

Addresses

NPPES NPI Registry

Primary practice location

7191 Cahaba Valley Rd
Suite 204
Birmingham, AL 35242-6402

Mailing address

7191 Cahaba Valley Rd
Suite 204
Birmingham, AL 35242-6402
Phone (205) 995-9967

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 12, 2013.

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370995200000",
    "number": "1174697106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7191 CAHABA VALLEY RD",
            "address_2": "SUITE 204",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352426402",
            "telephone_number": "205-995-9967",
            "fax_number": "205-995-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7191 CAHABA VALLEY RD",
            "address_2": "SUITE 204",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352426402",
            "telephone_number": "205-995-9967",
            "fax_number": "205-995-0635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PAIN SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2013-06-12",
        "status": "A",
        "authorized_official_last_name": "VARLEY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-995-9967",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "491",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AL",
            "license": "19582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.