Organization Active NPI

MD Pain Care PC

  • Specialist
  • Conyers, GA
National Provider Identifier
1396053286
Registry record updated Feb 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1744OOOOOX Issued in GA
Legal business name
MD PAIN CARE PC
Practice address
1301 Sigman Rd NE
Suite 100
Conyers, GA 30012-3812
Phone
(770) 760-9360
NPI assigned
Sep 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2013

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

Authorized official

Name
Dawne H Tunkel, CPC, CMPM, CPMCN
Title
Credentialing Direct
Phone
(865) 531-0176

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 1744OOOOOX GA Primary
Durable Medical Equipment & Medical Supplies 332B00000X 332BOOOOOX GA

Addresses

Primary practice location

1301 Sigman Rd NE
Suite 100
Conyers, GA 30012-3812

Mailing address

1301 Sigman Rd NE
Suite 100
Conyers, GA 30012-3812
Phone (770) 760-9360

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361836800000",
    "number": "1396053286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 SIGMAN RD NE",
            "address_2": "SUITE 100",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123812",
            "telephone_number": "770-760-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SIGMAN RD NE",
            "address_2": "SUITE 100",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123812",
            "telephone_number": "770-760-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD PAIN CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-14",
        "last_updated": "2013-02-26",
        "status": "A",
        "authorized_official_last_name": "TUNKEL",
        "authorized_official_first_name": "DAWNE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CREDENTIALING DIRECT",
        "authorized_official_telephone_number": "865-531-0176",
        "authorized_official_credential": "CPC, CMPM, CPMCN"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "1744OOOOOX",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "332BOOOOOX",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; 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.