Premier Spine Pain & Rehabilitation

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

200400934 Issued in NC

Legal business name

PREMIER SPINE PAIN & REHABILITATION

Practice address

2315 W Arbors Dr Ste 115
Charlotte, NC 28262-2639

Phone

(704) 817-6676

Fax

(704) 817-6678

NPI assigned

Feb 7, 2010

Last updated

Jun 23, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edward Anthony Overton, DONPI 1093753329

Title

Physician

Phone

(704) 817-6676

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Edward Anthony Overton, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Charlotte, NC
  • NPI 1093753329
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1265500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1770815300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 480328",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282695338",
            "telephone_number": "215-669-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 W ARBORS DR STE 115",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282622639",
            "telephone_number": "704-817-6676",
            "fax_number": "704-817-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SPINE PAIN & REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-07",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "OVERTON",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "704-817-6676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NC",
            "license": "200400934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.