Provider Demographics
NPI:1790728921
Name:INTEGRATED PAIN SOLUTIONS PLLC
Entity Type:Organization
Organization Name:INTEGRATED PAIN SOLUTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-291-7781
Mailing Address - Street 1:695 S BENNETT ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-5919
Mailing Address - Country:US
Mailing Address - Phone:910-725-1708
Mailing Address - Fax:910-725-1718
Practice Address - Street 1:695 S BENNETT ST
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-5919
Practice Address - Country:US
Practice Address - Phone:910-725-1708
Practice Address - Fax:910-725-1718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPainGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5900164Medicaid
NCDD3525OtherMEDICARE ID UNSPECIFIED
SCNPB085OtherSC MEDICAID
NC016VHOtherNC BLUE CROSS
NCDD3525OtherMEDICARE ID UNSPECIFIED
GADD3525Medicare PIN