Bowman Pain Management Center, PC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

BOWMAN PAIN MANAGEMENT CENTER, PC

Doing business as

Bowman Pain Management, PC

Practice address

6010 Lakeside Commons Dr
Suite a
Macon, GA 31210-5779

Phone

(478) 475-9220

Fax

(478) 475-9201

NPI assigned

Jul 25, 2006

Last updated

Sep 4, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Dwayne L Clay, M.D.NPI 1003829433

Title

Chief Executive Officer

Phone

(478) 475-9220

Specialties & licenses 1

Addresses

Other names 1

• Bowman Pain Management, PC Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417979550. Details of each certification follow.

• CCN 11C0001288 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 11C0001288

Legal name

BOWMAN PAIN MANAGEMENT, PC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jan 9, 2007

Last certification

Apr 29, 2021

Ownership / control type

Proprietary

Facility address

6010 Lakeside Commons Drive, Suite B
Macon, GA 31210

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

• Dwayne Lee Clay, M.D.

  • Interventional Pain Medicine Physician
  • Macon, GA
  • NPI 1003829433
  NPD Authorized official

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409788800000",
    "number": "1417979550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6010 LAKESIDE COMMONS DR",
            "address_2": "SUITE A",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312105779",
            "telephone_number": "478-475-9220",
            "fax_number": "478-475-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 LAKESIDE COMMONS DR",
            "address_2": "SUITE A",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312105779",
            "telephone_number": "478-475-9220",
            "fax_number": "478-475-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOWMAN PAIN MANAGEMENT CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2014-09-04",
        "status": "A",
        "authorized_official_last_name": "CLAY",
        "authorized_official_first_name": "DWAYNE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "478-475-9220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bowman Pain Management, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Renee Boudreaux, ATC
• Kristin Elizabeth Bourque, ATC
• Robert Bowen, PA-C
• Michael Bower
• Freedom Arlene Bowers
• John Norman Bowman Sr., D.D.S.
• Laura Bowman, CRNA
• Frank Bowyer, MD
• Zakiya Ty'Ana Boyce
• Monteager Lasha Boyd

• Pain Clinic/Center in Macon, GA
• Providers in Macon, GA by specialty
• Pain Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.