PREMIER PAIN PRACTICE PLLC (NPI# 1619348463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619348463 |
| Entity Type | Organization |
| Organization Name | PREMIER PAIN PRACTICE PLLC |
| Practice Address |
1782 Metromedical Dr Fayetteville NC 28304-3861 |
| Mailing Address |
308 Forest Creek Dr Fayetteville NC 28303-5493 |
| Practice Telephone | 9103397951 |
| Practice Fax Number | 9103397952 |
| Mailing Telephone | (910) 987-2571 |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2017-09-11 |
| Authorized Official Name | DR. SANJAY B SHAH (OWNER) |
| Authorized Official Telephone | 9109872571 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
1782 METROMEDICAL DR |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-3861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639568777 | Hollis L Jones Dds, Pllc | Clinic/Center | 1782 Metromedical Dr, Fayetteville, NC 28304-3861 | 2015-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215252481 | Whitney Kern Braddy | Anesthesiology | 2153 Valleygate Dr Ste 102, Fayetteville, NC 28304-3667 | 2010-03-31 |
| 1689878118 | Pain and Laser Cente Pa | Anesthesiology | 1840 Owen Drive, Suite 103, Fayetteville, NC 28304-3455 | 2007-06-11 |
| 1699828186 | Brent R Weilert | Anesthesiology | 3336 North Futrall Drive, Fayetteville, AR 72703 | 2007-01-19 |
| 1558428789 | Interventional Pain Center Pllc | Anesthesiology | 2153 Valleygate Dr, Suite 102, Fayetteville, NC 28304-3681 | 2007-01-03 |
| 1942301494 | Cumberland Anesthesia Associates P A | Anesthesiology | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174164057 | Regenerative Medical Institute,pllc | Anesthesiology | 1305 W. Wendover Ave., Ste A, Greensboro, NC 27408 | 2019-10-02 |
| 1598235830 | Mission Community Anesthesiology Specialists LLC | Anesthesiology | 89 Hospital Dr Ste C, Brevard, NC 28712-4838 | 2018-11-29 |
| 1508341736 | Bethany Medical Center | Anesthesiology | 190 Independence Ave Ste B, North Wilkesboro, NC 28659-4270 | 2018-10-03 |
| 1508347048 | Premier Pain Solutions Pllc | Anesthesiology | 5710 Oleander Dr Ste 201, Wilmington, NC 28403-4722 | 2018-08-23 |
| 1417434069 | Kyle Mason Fisher | Anesthesiology | Duke Univeristy Hospital Anesthesia Department, Durham, NC 27710-0001 | 2018-07-26 |
| 1306351432 | Carteret Surgical Associates P.a. | Anesthesiology | 2145 Country Club Rd Ste 400, Jacksonville, NC 28546-2400 | 2017-12-12 |
| 1003331521 | Accela Spine and Pain, Pllc | Anesthesiology | 10120 Ivey Chase Lane, Apt 617, Charlotte, NC 28277 | 2017-08-04 |
| 1205372588 | Interventional Pain Center, Pllc | Anesthesiology | 517 B Hwy 210 N, Spring Lake, NC 28390 | 2017-01-11 |
| 1316482201 | Providence Pain, Spine & Recovery, Pllc | Anesthesiology | 7 Berkshire Rd, Smithfield, NC 27577 | 2016-12-30 |
| 1356898720 | Ketamine Wellness Institute | Anesthesiology | 414 Cosgrove Ave, Chapel Hill, NC 27514-5271 | 2016-09-02 |
| Find all providers with the same taxonomy | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
Please comment or provide details below to improve the information on PREMIER PAIN PRACTICE PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.