NPIMap

Organization Active NPI

Serenity Pain Relief

  • Pain Medicine Physician
  • Suwanee, GA
National Provider Identifier
1215356571
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
47601 Issued in GA
Legal business name
SERENITY PAIN RELIEF
Practice address
2696 Lawrenceville Suwanee Rd
Suwanee, GA 30024-2535
Phone
(678) 376-1300
Fax
(678) 514-2936
NPI assigned
Apr 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Authorized official

Name
Philip Norton Henderson, MD
Title
President/Owner
Phone
(678) 376-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X 47601 GA Primary

Addresses

Primary practice location

2696 Lawrenceville Suwanee Rd
Suwanee, GA 30024-2535

Mailing address

2696 Lawrenceville Suwanee Rd
Suwanee, GA 30024-2535
Phone (678) 376-1300

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1215356571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2696 LAWRENCEVILLE SUWANEE RD",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242535",
            "telephone_number": "678-376-1300",
            "fax_number": "678-514-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2696 LAWRENCEVILLE SUWANEE RD",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242535",
            "telephone_number": "678-376-1300",
            "fax_number": "678-514-2936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY PAIN RELIEF",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "NORTON",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "678-376-1300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "GA",
            "license": "47601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.