NPIMap

Organization Active NPI

Valley Pain Clinic LLC

  • Pain Medicine (Anesthesiology) Physician
  • Decatur, AL
National Provider Identifier
1386944239
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
27458 Issued in AL
Legal business name
VALLEY PAIN CLINIC LLC
Practice address
2506 Danville Rd SW
Suite 206
Decatur, AL 35603-4232
Phone
(256) 301-9994
Fax
(256) 350-8763
NPI assigned
Oct 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

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

Authorized official

Name
Mr. Ahmad Shikhtholth, M.DNPI 1902987431
Title
President
Phone
(256) 301-9994

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X 27458 AL Primary

Addresses

Primary practice location

2506 Danville Rd SW
Suite 206
Decatur, AL 35603-4232

Mailing address

2506 Danville Rd SW
Suite 206
Decatur, AL 35603-4232
Phone (256) 301-9994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101227000440 AL Part B Supplier - Clinic/Group Practice 2961690581 Receives reassigned benefits from 3 practitioners
Practice locations: Decatur, AL

National Provider Directory

National Provider Directory

Locations

2208 Danville Rd SW
Ste G
Decatur, AL 35601
Phone (256) 301-9994

2205 Danville Rd SW Ste G
Decatur, AL 35601

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288051200000",
    "number": "1386944239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2506 DANVILLE RD SW",
            "address_2": "SUITE 206",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356034232",
            "telephone_number": "256-301-9994",
            "fax_number": "256-350-8763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2506 DANVILLE RD SW",
            "address_2": "SUITE 206",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356034232",
            "telephone_number": "256-301-9994",
            "fax_number": "256-350-8763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY PAIN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-26",
        "last_updated": "2010-10-26",
        "status": "A",
        "authorized_official_last_name": "SHIKHTHOLTH",
        "authorized_official_first_name": "AHMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-301-9994",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AL",
            "license": "27458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.