Chattanooga Pain Management Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

183 Issued in TN

Legal business name

CHATTANOOGA PAIN MANAGEMENT CENTER LLC

Practice address

1016 Executive Dr
Hixson, TN 37343-3995

Phone

(615) 376-7550

Fax

(615) 329-6290

NPI assigned

Jul 9, 2006

Organization subpart

No

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

Authorized official

Name

Kristen Oconnor

Title

Officer/Authorized Official

Phone

(615) 376-7315

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Chattanooga Pain Surgery Center Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Listed as

Chattanooga Pain Management Center LLC Dba Chattanooga Pain Surgery CenterCCN 44C0001155

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1245263292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 EXECUTIVE DR",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373433995",
            "telephone_number": "615-376-7550",
            "fax_number": "615-329-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 EXECUTIVE DR",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373433995",
            "telephone_number": "615-376-7550",
            "fax_number": "615-329-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHATTANOOGA PAIN MANAGEMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "OCONNOR",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-376-7315"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "183",
            "primary": true
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "TN",
            "license": "183",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3739688",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00267077",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Chattanooga Pain Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chattanooga Pain Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chattanooga Emergency Medicine PLLC
• Chattanooga Foot & Ankle PLLC
• Chattanooga General & Bariatric Surgery Inc
• Chattanooga Movement Center, LLC
• Chattanooga Orthopaedic Group, PC
• Chattanooga SH Operations LLC
• Chattanooga Spine and Body, Inc
• Chew Chew Dentistry
• Christopher Choe, MD
• Christopher Segler

• Ambulatory Surgical Clinic/Center in Hixson, TN
• Providers in Hixson, TN by specialty
• Ambulatory Surgical Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.