NPIMap

Organization Active NPI

Choice Pain & Rehabilitation Center, LLC

Doing business as Choice Pain and Rehabilitation Center

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Baltimore, MD
National Provider Identifier
1497203558
Registry record updated Jun 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
D0068884 Issued in MD
Legal business name
CHOICE PAIN & REHABILITATION CENTER, LLC
Doing business as
Choice Pain and Rehabilitation Center
Practice address
6615 Reisterstown Rd Ste 302
Baltimore, MD 21215-2689
Phone
(240) 786-1001
Fax
(240) 786-1002
NPI assigned
Sep 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2021

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

Authorized official

Name
Tristan J Shockley, MD
Title
Medical Director
Phone
(240) 786-1001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X D0068884 MD Primary

Addresses

Primary practice location

6615 Reisterstown Rd Ste 302
Baltimore, MD 21215-2689

Mailing address

8843 Greenbelt Rd Ste 117
Greenbelt, MD 20770-2451
Phone (240) 786-1001

Other practice location 1

4000 Old Court Rd
Suite 106
Pikesville, MD 21208-2800
Phone (240) 786-1001

Other names 2

  • CHOICE PAIN AND REHABILITATION CENTER Doing business as
  • Choice Pain & Rehabilitation Center, LLC Other name

National Provider Directory

National Provider Directory

Locations

4000 Old Court Rd
Ste 106
Pikesville, MD 21208

NPI Registry JSON

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624060800000",
    "number": "1497203558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8843 GREENBELT RD STE 117",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207702451",
            "telephone_number": "240-786-1001",
            "fax_number": "240-786-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6615 REISTERSTOWN RD STE 302",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212152689",
            "telephone_number": "240-786-1001",
            "fax_number": "240-786-1002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Old Court Rd",
            "address_2": "Suite 106",
            "address_purpose": "LOCATION",
            "city": "Pikesville",
            "state": "MD",
            "postal_code": "212082800",
            "country_code": "US",
            "telephone_number": "240-786-1001",
            "fax_number": "240-786-1002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHOICE PAIN & REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-19",
        "last_updated": "2021-06-19",
        "certification_date": "2021-06-19",
        "status": "A",
        "authorized_official_last_name": "SHOCKLEY",
        "authorized_official_first_name": "TRISTAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "240-786-1001",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MD",
            "license": "D0068884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHOICE PAIN AND REHABILITATION CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Choice Pain & Rehabilitation Center, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.