Regional Pain Center, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD31712 Issued in TN

Legal business name

REGIONAL PAIN CENTER, LLC

Practice address

6605 Stage Rd
Suite 1
Memphis, TN 38134-2808

Phone

(901) 800-1336

Fax

(901) 379-8955

NPI assigned

Sep 29, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Michael C Holliman, D.C.

Title

Ceo

Phone

(901) 800-1336

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1285037754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 908",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380880908",
            "telephone_number": "901-800-1336",
            "fax_number": "901-379-8955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6605 STAGE RD",
            "address_2": "SUITE 1",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381342808",
            "telephone_number": "901-800-1336",
            "fax_number": "901-379-8955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL PAIN CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-29",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "HOLLIMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "901-800-1336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC1282",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC1082",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD31712",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT8229",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Memphis, TN
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.