PAIN TREATMENT CENTER NPI 1174689533

NPI Information

NPI: 1174689533
Provider Name: PAIN TREATMENT CENTER
Classification: Clinic/Center - 261QP3300X
Specialization: Pain
Entity Type: Organization
CLIA Number: 25D1005524
Address: 106 ASBURY CIR
HATTIESBURG, MS
ZIP 39402
Phone: (601) 268-8698

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NPI Details

PAIN TREATMENT CENTER is a pain clinic center in Hattiesburg, MS. PAIN TREATMENT CENTER NPI is 1174689533. The provider is registered as an organization entity type.

The provider's business location address is:

106 ASBURY CIR
HATTIESBURG, MS
ZIP 39402-302
Phone: (601) 268-8698

The provider's authorized official is David L Mckellar .
The authorized official title is Ceo/medical Director and has the following contact phone number (601) 268-8698.

The CLIA number assigned to this NPI record is 25D1005524 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint (HCPCS:64635)
Injection of lower or sacral spine facet joint using imaging guidance, single level (HCPCS:64493)
Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography (HCPCS:G0260)
Injection of substance into lower spine canal using imaging guidance (HCPCS:62323)
Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level (HCPCS:64483)
Injection of substance into middle or upper spine canal using imaging guidance (HCPCS:62321)
Injection of upper or middle spine facet joint using imaging guidance, single level (HCPCS:64490)
Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint (HCPCS:64633)
Aspiration and/or injection of fluid from large joint (HCPCS:20610)
Destruction of nerves supplying joint between spine and pelvis using imaging guidance (HCPCS:64625)

The enumeration date for this NPI number is 12/29/2006 and was last updated on 1/20/2011.

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
1	261QP3300X	Clinic/Center	Pain			Yes

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
1	490000026	MEDICARE PIN	MISSISSIPPI
2	00770530	MEDICAID	MISSISSIPPI
3	25C0001032	OTHER	MISSISSIPPI	ASC ID NUMBER

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: 3/30/2025

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