NPIMap

Organization Active NPI

Southeastern Pain Management Center, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Bristol, TN
National Provider Identifier
1326053760
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
SOUTHEASTERN PAIN MANAGEMENT CENTER, PLLC
Practice address
3183 W State St
Suite 1101
Bristol, TN 37620-1712
Phone
(423) 968-2772
Fax
(423) 968-1377
NPI assigned
Jul 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dennis M Aguirre, MDNPI 1376588996
Title
Medical Director
Phone
(423) 968-4540

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 (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

3183 W State St
Suite 1101
Bristol, TN 37620-1712

Mailing address

350 Blountville Hwy
Ste 207
Bristol, TN 37620-0213
Phone (423) 968-4540

Other names 1

  • SOUTHEASTERN PAIN MANAGEMENT CENTER Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326053760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 BLOUNTVILLE HWY",
            "address_2": "STE 207",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376200213",
            "telephone_number": "423-968-4540",
            "fax_number": "423-968-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3183 W STATE ST",
            "address_2": "SUITE 1101",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201712",
            "telephone_number": "423-968-2772",
            "fax_number": "423-968-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN PAIN MANAGEMENT CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AGUIRRE",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "423-968-4540",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHEASTERN PAIN MANAGEMENT CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.