White Mountain Pain Clinic, PLLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

1-083260 Issued in AL

Legal business name

WHITE MOUNTAIN PAIN CLINIC, PLLC

Practice address

5721 5TH CT S
Birmingham, AL 35212-3211

Phone

(205) 567-0832

NPI assigned

Nov 25, 2016

Organization subpart

No

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

Authorized official

Name

John C Allen, M.S., D.A.A.E.T.S.NPI 1063455541

Title

Grantor

Phone

(205) 567-0832

Specialties & licenses 1

Addresses

Other names 1

• The Allen Family Irrevocable Trust Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Clifford Allen, M.S., D.A.A.E.T.S.

  • Registered Nurse
  • Birmingham, AL
  • NPI 1063455541
  NPD (past) Authorized official

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

{
    "created_epoch": "1480032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480118400000",
    "number": "1972046803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 531166",
            "city": "MOUNTAIN BROOK",
            "state": "AL",
            "postal_code": "352531166",
            "telephone_number": "205-567-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5721 5TH CT S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352123211",
            "telephone_number": "205-567-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE MOUNTAIN PAIN CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-25",
        "last_updated": "2016-11-26",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "GRANTOR",
        "authorized_official_telephone_number": "205-567-0832",
        "authorized_official_credential": "M.S., D.A.A.E.T.S."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "AL",
            "license": "1-083260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Allen Family Irrevocable Trust",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Chernise Camberian Whitaker, CHERNISE RAPLEY
• Olivia Whitaker
• Tyler Whitaker, MD
• William Vernon Whitaker, M.D.
• Chanley Alexa Whitcomb
• Qiana Larice White-Acker, LPC, ICADC
• Adeline White, CRNP
• Andrea R White, MD
• Andrew White, D.O.
• Ashley White

• Pain Clinic/Center in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Pain Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.