Preferred Pain Center of Grundy County

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

PREFERRED PAIN CENTER OF GRUNDY COUNTY

Practice address

32717 Sr 108
Gruetli Laager, TN 37339

Phone

(931) 779-2225

Fax

(931) 779-2226

NPI assigned

Nov 28, 2012

Last updated

Sep 27, 2013By 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

Charlotte D Marks

Title

Billing Manager

Phone

(931) 779-2225

Specialties & licenses 3

Addresses

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.

• Councill C Rudolph, MD

  • Surgery Physician
  • Manchester, TN
  • NPI 1194760660
  NPD (past)

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1508101734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 258",
            "city": "GRUETLI LAAGER",
            "state": "TN",
            "postal_code": "373390258",
            "telephone_number": "931-779-2225",
            "fax_number": "931-779-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32717 SR 108",
            "city": "GRUETLI LAAGER",
            "state": "TN",
            "postal_code": "37339",
            "telephone_number": "931-779-2225",
            "fax_number": "931-779-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED PAIN CENTER OF GRUNDY COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-28",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "MARKS",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "931-779-2225"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Farris, OTD, OTR/L
• Monica Meeks, NP
• Mountain Kind Therapy Services
• Alexandra Repke, PHD

• Physician Assistant in Gruetli Laager, TN
• Providers in Gruetli Laager, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; 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.