Cumberland Back Pain Clinic

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA918 Issued in TN

Legal business name

CUMBERLAND BACK PAIN CLINIC

Doing business as

The Pain Center of Kingsport

Practice address

1732 N Eastman Rd
Kingsport, TN 37664-2376

Phone

(615) 591-2754

Fax

(615) 591-2755

NPI assigned

May 24, 2007

Organization subpart

No

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

Authorized official

Name

Annette M Dreifke

Title

Billing Manager

Phone

(615) 591-2754

Specialties & licenses 1

Addresses

Other names 1

• The Pain Center of Kingsport Doing business as

Tax ID family

Cumberland Back Pain Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Cumberland Back Pain Clinic

  • Adult Health Nurse Practitioner
  • Hendersonville, NC
  • NPI 1871791335
  NPD tax ID

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932310828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1732 N EASTMAN RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376642376",
            "telephone_number": "615-591-2754",
            "fax_number": "615-591-2755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 N EASTMAN RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376642376",
            "telephone_number": "615-591-2754",
            "fax_number": "615-591-2755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND BACK PAIN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DREIFKE",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "615-591-2754"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Pain Center of Kingsport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Marie Crowley-Rodig, ARNP
• Chelsea Jeanette Cruey, RN
• Julia Wallin Culligan, PH.D.
• Lauren Ashley Cullins, APRN, CPNP-AC
• Benjamin Culp, MD
• Howard Lee Cummings, M.D.
• Scott Matthew Cureton, DDS
• Steven Lee Cureton, DMD MS
• Lauren Ernst Curry, APRN, FNP-C
• Custom Orthotics & Prosthetics

• Physician Assistant in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.