Waldorf Pain & Rehabilitation Center, LLC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

01649 Issued in MD

Legal business name

WALDORF PAIN & REHABILITATION CENTER, LLC

Practice address

3050 Crain Hwy
7100 Peachtree Dunwoody Road
Waldorf, MD 20601-2824

Phone

(240) 357-0342

NPI assigned

Mar 24, 2016

Last updated

Mar 24, 2016By 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

Atlee Wampler IV, DC

Title

Ceo/Owner

Phone

(678) 524-6828

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1458777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458777600000",
    "number": "1942662424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 566455",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311566455",
            "telephone_number": "770-504-5162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 CRAIN HWY",
            "address_2": "7100 PEACHTREE DUNWOODY ROAD",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206012824",
            "telephone_number": "240-357-0342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALDORF PAIN & REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-24",
        "last_updated": "2016-03-24",
        "status": "A",
        "authorized_official_last_name": "WAMPLER IV",
        "authorized_official_first_name": "ATLEE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "678-524-6828",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MD",
            "license": "01649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East, LP (Vision Center 30-1717)
• Walden Sierra Corp
• Waldorf Anesthesia Services LLC
• Waldorf Family and Cosmetic Dentistry
• Waldorf Oral Surgery LLC
• Waldorf Primary Care LLC
• Waldorf SNF Operations LLC (Waldorf Center)
• Waldorf SNF Operations LLC (Waldorf Center)
• Waldorf Volunteer Fire Department, Inc. (Waldorf Volunteer Fire Department)
• Walgreen Co (Walgreens #09032)

• Rehabilitation Chiropractor in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Rehabilitation Chiropractor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.