NPIMap

Organization Active NPI

Pain and Spine Specialists of Maryland, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Mount Airy, MD
National Provider Identifier
1396338448
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
PAIN AND SPINE SPECIALISTS OF MARYLAND, LLC
Practice address
1704 Back Acre Cir
Mount Airy, MD 21771-7768
Phone
(301) 703-8767
NPI assigned
Feb 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Authorized official

Name
Staci Powell
Title
Director of Operations
Phone
(443) 701-9295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

1704 Back Acre Cir
Mount Airy, MD 21771-7768

Mailing address

2702 Back Acre Cir # 290B
Mount Airy, MD 21771-7769
Phone (301) 703-8767

National Provider Directory

National Provider Directory
Tax ID family
Pain Spine Specs of MD16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

2702 Back Acre Cir
#290B
Mount Airy, MD 21771

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615420800000",
    "number": "1396338448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 BACK ACRE CIR # 290B",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217717769",
            "telephone_number": "301-703-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 BACK ACRE CIR",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217717768",
            "telephone_number": "301-703-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN AND SPINE SPECIALISTS OF MARYLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "STACI",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "443-701-9295"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.