Organization Active NPI

Center for Pain Management PLLC

  • Interventional Pain Medicine Physician
  • Wilmington, NC
National Provider Identifier
1528063542
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
1234 Issued in NC
Legal business name
CENTER FOR PAIN MANAGEMENT PLLC
Practice address
1602 Physicians Dr Ste 103
Wilmington, NC 28401-7350
Phone
(910) 442-1200
Fax
(910) 442-1297
NPI assigned
Jun 16, 2005
Last updated
Sep 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Authorized official

Name
John H Knab, MDNPI 1265437008
Title
Medical Director
Phone
(910) 442-1200

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
Interventional Pain Medicine Physician 208VP0014X 1234 NC Primary

Addresses

Primary practice location

1602 Physicians Dr Ste 103
Wilmington, NC 28401-7350

Mailing address

1602 Physicians Dr Ste 103
Wilmington, NC 28401-7350
Phone (910) 442-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040128000852 NC Part B Supplier - Clinic/Group Practice 0941103980 Receives reassigned benefits from 2 practitioners
Practice locations: Wilmington, NC
O20150814014285 NC DME Supplier - Physician - Unknown Physician Specialty 0941103980 Practice locations: Wilmington, NC

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1091465Center for Pain Management1602 Physicians Dr Ste 103, Wilmington, NC 28401Certificate of waiverNov 2, 2026

National Provider Directory

National Provider Directory

Locations

1602 Physicians Dr
Ste 103
Wilmington, NC 28401
Phone (910) 442-1200

2208 S 17th St
Ste 102
Wilmington, NC 28401
Phone (910) 442-1200

2513 Delaney Ave
Wilmington, NC 28403
Phone (910) 254-4040

Practitioners & affiliated clinicians

Practitioners 9

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": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598918400000",
    "number": "1528063542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 PHYSICIANS DR STE 103",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017350",
            "telephone_number": "910-442-1200",
            "fax_number": "910-442-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 PHYSICIANS DR STE 103",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017350",
            "telephone_number": "910-442-1200",
            "fax_number": "910-442-1297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PAIN MANAGEMENT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A",
        "authorized_official_last_name": "KNAB",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "910-442-1200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NC",
            "license": "1234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.