Provider Demographics
NPI:1639509664
Name:PAIN MD LLC
Entity Type:Organization
Organization Name:PAIN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:CARROLL
Authorized Official - Middle Name:E
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:615-435-0553
Mailing Address - Street 1:PO BOX 681789
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-1789
Mailing Address - Country:US
Mailing Address - Phone:615-503-9000
Mailing Address - Fax:615-435-0549
Practice Address - Street 1:725 COOL SPRINGS BLVD
Practice Address - Street 2:STE. 550
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2702
Practice Address - Country:US
Practice Address - Phone:615-503-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ005805Medicaid
TN103G705716Medicare PIN
TNQ005805Medicaid
NCD540Medicare PIN