NPIMap

Organization Active NPI

North Alabama Rehabilitation and Pain Specialist LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Decatur, AL
National Provider Identifier
1477839769
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
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
Last updated
Nov 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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

Authorized official

Name
Dr. Mark Olusegun Awoniyi, M.D.NPI 1528180403
Title
Organizer
Phone
(256) 604-0671

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 30296 AL Primary

Addresses

Primary practice location

2046 Beltline Rd SW
Decatur, AL 35601-5549

Mailing address

2046 Beltline Rd SW
Decatur, AL 35601-5549
Phone (256) 353-0410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20111102000272 AL Part B Supplier - Clinic/Group Practice 8022281328 Receives reassigned benefits from 1 practitioner
Practice locations: Decatur, AL
O20121121000435 AL DME Supplier - Physician - Physical and Rehabilitation 8022281328 Practice locations: Decatur, AL

National Provider Directory

National Provider Directory

Locations

1852 Beltline Rd SW
Ste D
Decatur, AL 35601
Phone (205) 351-0688

2046 Beltline Rd SW
Decatur, AL 35601
Phone (256) 353-0410

Practitioners & affiliated clinicians

Practitioners 8

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": "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": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "AL",
            "license": "30296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • 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.