Organization Active NPI

TMC Tanner Pain Management Inc

  • Pain Medicine Physician
  • Bremen, GA
National Provider Identifier
1639637762
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
TMC TANNER PAIN MANAGEMENT INC
Practice address
204 Allen Memorial Dr Ste 302a
Bremen, GA 30110-2047
Phone
(770) 812-5720
Fax
(770) 836-9663
NPI assigned
Mar 7, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Authorized official

Name
Clint Hoffman
Title
Sr VP
Phone
(770) 838-8302

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

204 Allen Memorial Dr Ste 302a
Bremen, GA 30110-2047

Mailing address

100 Greenway Blvd FL 2
Carrollton, GA 30117-4338
Phone (770) 838-8710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190516002490 GA Part B Supplier - Clinic/Group Practice 9638412562 Receives reassigned benefits from 1 practitioner
Practice locations: Bremen, GA

National Provider Directory

National Provider Directory

Locations

204 Allen Memorial Dr
Ste 302
Bremen, GA 30110
Phone (770) 836-9326

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1639637762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GREENWAY BLVD FL 2",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174338",
            "telephone_number": "770-838-8710",
            "fax_number": "770-812-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 ALLEN MEMORIAL DR STE 302A",
            "city": "BREMEN",
            "state": "GA",
            "postal_code": "301102047",
            "telephone_number": "770-812-5720",
            "fax_number": "770-836-9663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TMC TANNER PAIN MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-07",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "CLINT",
        "authorized_official_title_or_position": "SR VP",
        "authorized_official_telephone_number": "770-838-8302"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremen, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.