NPIMap

Organization Active NPI

MD Pain Relief Center, LLC

  • Specialist
  • Columbia, MD
National Provider Identifier
1689973042
Registry record updated Jul 5, 2012
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Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D0053730 Issued in MD
Legal business name
MD PAIN RELIEF CENTER, LLC
Practice address
10760 Hickory Ridge Rd
Suite 117
Columbia, MD 21044-3682
Phone
(410) 302-0700
NPI assigned
Mar 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

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

Authorized official

Name
Dr. Gang Li, M.D.
Title
Chief Executive Manager
Phone
(410) 302-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X D0053730 MD Primary

Addresses

Primary practice location

10760 Hickory Ridge Rd
Suite 117
Columbia, MD 21044-3682

Mailing address

PO Box 100
Glenelg, MD 21737-0100
Phone (410) 302-0700

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341446400000",
    "number": "1689973042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "GLENELG",
            "state": "MD",
            "postal_code": "217370100",
            "telephone_number": "410-302-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10760 HICKORY RIDGE RD",
            "address_2": "SUITE 117",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443682",
            "telephone_number": "410-302-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD PAIN RELIEF CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-23",
        "last_updated": "2012-07-05",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "GANG",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE MANAGER",
        "authorized_official_telephone_number": "410-302-0700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0053730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; 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.