NPIMap

Organization Active NPI

Choice Pain & Rehabilitation Center, LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Rosedale, MD
National Provider Identifier
1225588676
Registry record updated Jun 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
D0068884 Issued in MD
Legal business name
CHOICE PAIN & REHABILITATION CENTER, LLC
Practice address
7106 Ridge Rd Ste 100
Rosedale, MD 21237-3876
Phone
(240) 786-1001
Fax
(240) 786-1002
NPI assigned
Oct 10, 2016
Last updated
Jun 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2021

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

Authorized official

Name
Tristan J Shockley, MDNPI 1932242542
Title
Medical Director
Phone
(240) 786-1001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X D0068884 MD Primary

Addresses

Primary practice location

7106 Ridge Rd Ste 100
Rosedale, MD 21237-3876

Mailing address

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

Other practice location 1

5430 Campbell Blvd
Suite 106
White Marsh, MD 21162-5500
Phone (240) 786-1001

Other names 1

  • Choice Pain & Rehabilitation Center, LLC Other name

National Provider Directory

National Provider Directory

Locations

8843 Greenbelt Rd
Greenbelt, MD 20770
Phone (202) 689-4398

7106 Ridge Rd
Ste 100
Rosedale, MD 21237
Phone (410) 686-5635

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": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624060800000",
    "number": "1225588676",
    "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",
            "fax_number": "240-786-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7106 RIDGE RD STE 100",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212373876",
            "telephone_number": "240-786-1001",
            "fax_number": "240-786-1002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5430 Campbell Blvd",
            "address_2": "SUITE 106",
            "address_purpose": "LOCATION",
            "city": "White Marsh",
            "state": "MD",
            "postal_code": "211625500",
            "country_code": "US",
            "telephone_number": "240-786-1001",
            "fax_number": "240-786-1002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHOICE PAIN & REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2021-06-19",
        "certification_date": "2021-06-19",
        "status": "A",
        "authorized_official_last_name": "SHOCKLEY",
        "authorized_official_first_name": "TRISTAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "240-786-1001",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MD",
            "license": "D0068884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Choice Pain & Rehabilitation Center, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rosedale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2021; 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.