Active NPI
MD Pain Care PC
- Specialist
- Conyers, GA
National Provider Identifier
1396053286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 1744OOOOOX
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 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 DirectoryNPI 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.