Premier Pain Practice PLLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

PREMIER PAIN PRACTICE PLLC

Practice address

1782 Metromedical Dr
Fayetteville, NC 28304-3861

Phone

(910) 339-7951

Fax

(910) 339-7952

NPI assigned

Oct 19, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Sanjay B Shah, M.D.

Title

Owner

Phone

(910) 987-2571

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666915200000",
    "number": "1619348463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1782 METROMEDICAL DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043861",
            "telephone_number": "910-339-7951",
            "fax_number": "910-339-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1782 METROMEDICAL DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043861",
            "telephone_number": "910-339-7951",
            "fax_number": "910-339-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PAIN PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-19",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "SANJAY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-987-2571",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Anesthesiology) Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Pain Medicine (Anesthesiology) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.