Laurel Pain Clinic PA

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

16318 Issued in MS

Legal business name

LAUREL PAIN CLINIC PA

Practice address

1706 W 12TH St
Laurel, MS 39440-2559

Phone

(601) 369-2021

NPI assigned

Sep 25, 2006

Last updated

Nov 6, 2012By 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

Ashley N Buie

Title

Billing Supervisor

Phone

(601) 898-7530

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

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 16

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.

• Vivek Barclay, MD

  • Anesthesiology Physician
  • Laurel, MS
  • NPI 1578594586

  Interventional Pain Medicine

  Medicare reassignment Care Compare group NPD
• Wendi Dungan, RN, BSN, MSN, FNP

  • Pain Medicine Physician
  • Laurel, MS
  • NPI 1003775842
  Medicare reassignment Care Compare group NPD
• Angela Rachelle Freeman, FNP

  • Family Nurse Practitioner
  • Laurel, MS
  • NPI 1265015218
  Medicare reassignment Care Compare group NPD
• Megan Eileen Peak, AGNP

  • Nurse Practitioner
  • Laurel, MS
  • NPI 1457089302
  Medicare reassignment Care Compare group NPD
• Ashley Brooks

  • Family Nurse Practitioner
  • Laurel, MS
  • NPI 1164062295
  Medicare reassignment NPD
• April Hosey, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Laurel, MS
  • NPI 1730836958
  Medicare reassignment NPD
• Emily Key, FNP

  • Family Nurse Practitioner
  • Seminary, MS
  • NPI 1821525593
  Medicare reassignment NPD
• Lindsay Luke, FNP

  • Nurse Practitioner
  • Laurel, MS
  • NPI 1912676313
  Medicare reassignment NPD
• Darius R. McGee, FNP

  • Family Nurse Practitioner
  • Laurel, MS
  • NPI 1619004744
  Medicare reassignment NPD
• Britney Lanise Nobles, FNP

  • Family Nurse Practitioner
  • Laurel, MS
  • NPI 1962256628
  Medicare reassignment NPD
• Herbert Graham Rogers, M.D.

  • Internal Medicine Physician
  • Laurel, MS
  • NPI 1720092331
  Medicare reassignment NPD
• Amanda Danielle Simpson

  • Nurse Practitioner
  • Meridian, MS
  • NPI 1003334301
  Medicare reassignment NPD

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352160000000",
    "number": "1811098874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 W 12TH ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394402559",
            "telephone_number": "601-369-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 W 12TH ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394402559",
            "telephone_number": "601-369-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL PAIN CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2012-11-06",
        "status": "A",
        "authorized_official_last_name": "BUIE",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "601-898-7530"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MS",
            "license": "16318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09987586",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF1770",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurel Ear, Nose, and Throat Surgical Clinic
• Laurel Eye Clinic, PC
• Laurel Oaks Dental Care
• Laurel Obstetrics and Gynecology PA
• Laurel Orthodontic Associates LLC (Smile Country Orthodontics)
• Laurel Pharmacy, LLC
• Laurel Plastic Surgery LLC
• Laurel Speech, Language and Hearing Ctr
• Laurel Surgery & Endoscopy Center, LLC (Laurel Surgery & Endo Anesthesia)
• Laurel Surgery & Endoscopy Center, LLC

• Interventional Pain Medicine Physician in Laurel, MS
• Providers in Laurel, MS by specialty
• Interventional Pain Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.