Provider Demographics
NPI:1215596135
Name:PAIN MANAGEMENT PLUS PLLC
Entity Type:Organization
Organization Name:PAIN MANAGEMENT PLUS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HEWITT
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:828-919-2393
Mailing Address - Street 1:PO BOX 1641
Mailing Address - Street 2:
Mailing Address - City:BRYSON CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28713-1641
Mailing Address - Country:US
Mailing Address - Phone:980-279-5801
Mailing Address - Fax:828-538-4441
Practice Address - Street 1:249 OAK ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-3585
Practice Address - Country:US
Practice Address - Phone:980-279-5801
Practice Address - Fax:828-919-2394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-13
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6815645OtherUHC
NCDZ3967OtherRAILROAD MEDICARE
NC02FLROtherBCBS NC
NC1215596135Medicaid
SCNPC102Medicaid
NCJ277OtherMEDICARE
NC10125636OtherMULTIPLAN
NCQY95OtherBLUE MEDICARE