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ADVANCED SPINE AND PAIN CENTER P.A. NPI 1003275603


NPI Information

NPI: 1003275603
Provider Name: ADVANCED SPINE AND PAIN CENTER, P.A.
Classification: Physical Medicine & Rehabilitation - 2081P2900X
Entity Type: Organization

Specialization: Pain Medicine

CLIA Number: 34D2164512

Address:
166 SPRINGBROOK AVE
SUITE 105
CLAYTON, NC
ZIP 27520
Phone: (919) 359-8643
Get Directions

ADVANCED SPINE AND PAIN CENTER, P.A. is a pain medicine physical medicine rehabilitation in Clayton, NC. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. ADVANCED SPINE AND PAIN CENTER, P.A. NPI is 1003275603. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

166 SPRINGBROOK AVE
SUITE 105
CLAYTON, NC
ZIP 27520-520
Phone: (919) 359-8643

The provider's authorized official is Rachid Idrissi .
The authorized official title is Physician Owner and has the following contact phone number (919) 894-1740.

The CLIA number assigned to this NPI record is 34D2164512 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/11/2016 and was last updated on 2/11/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208VP0000XPain MedicinePain MedicineNo
22081P2900XPhysical Medicine & RehabilitationPain MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12022043AMEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.