NPIMap

Organization Active NPI

Choice Pain & Rebabilitation Center LLC

  • Non-Pharmacy Dispensing Site
  • Bowie, MD
National Provider Identifier
1922469865
Registry record updated Mar 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
D0068884 Issued in MD
Legal business name
CHOICE PAIN & REBABILITATION CENTER LLC
Practice address
5102 Cornelias Prospect Dr
Bowie, MD 20720-3375
Phone
(240) 786-1001
NPI assigned
Mar 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2016

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

Authorized official

Name
Tristan ShockleyNPI 1932242542
Title
Owner
Phone
(240) 786-1001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X D0068884 MD Primary

Addresses

Primary practice location

5102 Cornelias Prospect Dr
Bowie, MD 20720-3375

Mailing address

5102 Cornelias Prospect Dr
Bowie, MD 20720-3375
Phone (240) 786-1001

National Provider Directory

National Provider Directory
Tax ID family
Choice Pain and Rehabilitation Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

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": "1458259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458259200000",
    "number": "1922469865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5102 CORNELIAS PROSPECT DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207203375",
            "telephone_number": "240-786-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5102 CORNELIAS PROSPECT DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207203375",
            "telephone_number": "240-786-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOICE PAIN & REBABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-18",
        "last_updated": "2016-03-18",
        "status": "A",
        "authorized_official_last_name": "SHOCKLEY",
        "authorized_official_first_name": "TRISTAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-786-1001"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "MD",
            "license": "D0068884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; 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.