Charlotte Pain Clinic Incorporated

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

ME16509 Issued in FL

Legal business name

CHARLOTTE PAIN CLINIC INCORPORATED

Practice address

3109 Tamiami TRL
Unit 3
Port Charlotte, FL 33952-8046

Phone

(941) 629-3000

Fax

(941) 629-6711

NPI assigned

Nov 8, 2007

Organization subpart

No

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

Authorized official

Name

Nancy J Harris, RN

Title

Owner

Phone

(941) 629-3000

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1932389764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 TAMIAMI TRL",
            "address_2": "UNIT 3",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528046",
            "telephone_number": "941-629-3000",
            "fax_number": "941-629-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 TAMIAMI TRL",
            "address_2": "UNIT 3",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528046",
            "telephone_number": "941-629-3000",
            "fax_number": "941-629-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE PAIN CLINIC INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-629-3000",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME16509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE",
            "identifier": "RN1855592",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlotte Internal Medicine Associates, P.a.
• Charlotte Nephrology Associates PA
• Charlotte Optical Inc
• Charlotte Orthopaedic Clinic Professional Association
• Charlotte Pain Center Inc
• Charlotte Pain Management Center Inc
• Charlotte Resources Inc (The MRI Center of Charlotte County)
• Gabriela Chavez Soler
• Chelsea Place Adult Day Care LLC (ActivAge At Chelsea Place)
• Chelsea Place Home Care LLC

• Pain Medicine Physician in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Pain Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.