NPIMap

Organization Active NPI

Center for Pain Management, LLC

  • Interventional Pain Medicine Physician
  • Frederick, MD
National Provider Identifier
1710286190
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
CENTER FOR PAIN MANAGEMENT, LLC
Practice address
75 Thomas Johnson Dr
Ste C
Frederick, MD 21702-4895
Phone
(301) 620-0012
Fax
(301) 620-9687
NPI assigned
Mar 24, 2011
Last updated
Dec 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Authorized official

Name
Shaneka Tinch
Title
RCM Manager
Phone
(469) 458-9222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X NU Primary

Addresses

Primary practice location

75 Thomas Johnson Dr
Ste C
Frederick, MD 21702-4895

Mailing address

4960 SW 72ND Ave Ste 405
Miami, FL 33155-5506
Phone (469) 458-9222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110404000156 MD DME Supplier - Physician - Interventional Pain Management 0547246555 Practice locations: Frederick, MD

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765152000000",
    "number": "1710286190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4960 SW 72ND AVE STE 405",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331555506",
            "telephone_number": "469-458-9222",
            "fax_number": "540-918-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 THOMAS JOHNSON DR",
            "address_2": "STE C",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024895",
            "telephone_number": "301-620-0012",
            "fax_number": "301-620-9687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PAIN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-24",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A",
        "authorized_official_last_name": "TINCH",
        "authorized_official_first_name": "SHANEKA",
        "authorized_official_title_or_position": "RCM MANAGER",
        "authorized_official_telephone_number": "469-458-9222"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.