North Alabama Rehabilitation and Pain Specialist LLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

30296 Issued in AL

Legal business name

NORTH ALABAMA REHABILITATION AND PAIN SPECIALIST LLC

Practice address

2046 Beltline Rd SW
Decatur, AL 35601-5549

Phone

(256) 353-0410

Fax

(256) 353-0649

NPI assigned

Oct 31, 2011

Organization subpart

No

Name

Dr. Mark Olusegun Awoniyi, M.D.NPI 1528180403

Title

Organizer

Phone

(256) 604-0671

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

• Mark Awoniyi, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Decatur, AL
  • NPI 1528180403

  AL, Pain Medicine

  Medicare reassignment NPD Authorized official
• Wilnelsia A Awoniyi, DPM

  • Podiatrist
  • Decatur, AL
  • NPI 1396796116
  NPD
• Jeremiah Irby

  • Physical Therapist
  • Madison, AL
  • NPI 1740004209
  NPD
• Pauline A Lett-Anderson, M.D.

  • Internal Medicine Physician
  • Athens, AL
  • NPI 1437285574
  NPD
• Kendra Rodgers, NURSE PRACTITIONER

  • Gerontology Nurse Practitioner
  • Fayetteville, TN
  • NPI 1134752975
  NPD
• Moses A Awoniyi, M.D.

  • Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
  • Decatur, AL
  • NPI 1306060371
  NPD (past)
• Wilatra Awoniyi, D.D.S.

  • General Practice Dentistry
  • Decatur, AL
  • NPI 1013030766
  NPD (past)
• Angela Pruitt Durham, N.P.

  • Family Nurse Practitioner
  • Madison, AL
  • NPI 1699862474
  NPD (past)
• Kristen Elizabeth Mabry, RN

  • Nurse Practitioner
  • Decatur, AL
  • NPI 1952987653
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in AL2 enrollments

Enrollment records 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 1, 2011.

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1477839769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2046 BELTLINE RD SW",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356015549",
            "telephone_number": "256-353-0410",
            "fax_number": "256-353-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2046 BELTLINE RD SW",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356015549",
            "telephone_number": "256-353-0410",
            "fax_number": "256-353-0649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH ALABAMA REHABILITATION AND PAIN SPECIALIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-31",
        "last_updated": "2011-11-01",
        "status": "A",
        "authorized_official_last_name": "AWONIYI",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "OLUSEGUN",
        "authorized_official_title_or_position": "ORGANIZER",
        "authorized_official_telephone_number": "256-604-0671",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "AL",
            "license": "30296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Alabama Home Dialysis
• North Alabama Internal Medicine,PC
• North Alabama Pain Services
• North Alabama Pain SVCS, LLC
• North Alabama Radiology
• North Central Alabama Mental Retardation Authority, Inc.
• North Central Alabama Mental Retardation Authority, Inc.
• North Central Alabama Regional Council of Governments
• Northern Alabama Physicians, LLP
• Northland Hearing Centers, Inc.

• All providers in Decatur, AL
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.