COVENANT PAIN THERAPIES CENTER, LLC (NPI# 1235671231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235671231 |
| Entity Type | Organization |
| Organization Name | COVENANT PAIN THERAPIES CENTER, LLC |
| Other Organization Name | COVENANT PAIN CENTER |
| Practice Address |
3007 Memorial Pkwy Sw Huntsville AL 35801-5393 |
| Mailing Address |
Po Box 18084 Huntsville AL 35804-8084 |
| Practice Telephone | 2568822003 |
| Practice Fax Number | 2567054630 |
| Mailing Telephone | 2568822003 |
| Mailing Fax Number | 2567054630 |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2017-01-10 |
| Authorized Official Name | KENNETH DEAN WILLIS (SOLE MEMBER) |
| Authorized Official Telephone | 2568822003 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
12320 | AL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Covenant Pain Center | Doing Business As Name - Organization |
| Street Address |
3007 MEMORIAL PKWY SW |
| City | HUNTSVILLE |
| State | AL |
| Zip Code | 35801-5393 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952305518 | Charles A Hagen | Emergency Medicine | 3007 Memorial Pkwy Sw, Huntsville, AL 35801-5393 | 2005-06-10 |
| 1821412396 | Betsy Mcculloch Osborn | Nurse Practitioner | 3007 Memorial Pkwy Sw, Huntsville, AL 35801-5393 | 2014-02-04 |
| 1346679834 | Zaheer A Khan Md PC | Internal Medicine | 3007 Memorial Pkwy Sw, Suite B, Huntsville, AL 35801-5393 | 2013-11-05 |
| 1588003735 | Julie Ellen Mccormick | Nurse Practitioner | 3007 Memorial Pkwy Sw, Suite B, Huntsville, AL 35801-5393 | 2013-06-20 |
| 1073803680 | Patricia Phillips Elmore | Nurse Practitioner | 3007 Memorial Pkwy Sw, Ste C, Huntsville, AL 35801-5393 | 2011-04-15 |
| 1861724569 | Laura E. Dyer Md PC | Emergency Medicine | 3007 Memorial Pkwy Sw, Suite B, Huntsville, AL 35801-5393 | 2010-02-04 |
| 1952631426 | Elderly Care Associates | Clinic/Center | 3007 Memorial Pkwy Sw, Suite B, Huntsville, AL 35801-5393 | 2010-01-06 |
| 1275710717 | Diana Marie Hankey Underwood | Nurse Practitioner | 3007 Memorial Pkwy Sw, Huntsville, AL 35801-5393 | 2008-01-28 |
| 1134264567 | Pearle Vision | Technician/Technologist | 3007 Memorial Pkwy Sw, Huntsville, AL 35801-5393 | 2007-02-21 |
| 1053486704 | Kenneth Dean Willis | Anesthesiology | 3007 Memorial Pkwy Sw, Huntsville, AL 35801-5393 | 2006-11-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422742 | Elena Mihaela Kruse | Nurse Practitioner | 415 Echurch St, Nw Suite 4, Huntsville, AL 35801 | 2020-09-18 |
| 1225657661 | Ashley Danielle Ford | Student in an Organized Health Care Education/Training Program | 301 Governors Drive Se, Huntsville, AL 35801 | 2020-04-15 |
| 1407417702 | Sasha J White | Specialist | 410 Governors Dr. Sw, Huntsville, AL 35801 | 2019-06-26 |
| 1003472978 | Gina Marie Delgado | Nurse Practitioner | Huntsville Hospital Cvicu, 101 Sivley Rd., Huntsville, AL 35801 | 2019-05-15 |
| 1366909863 | Lisa Starkey Suggs | Nurse Practitioner | 3500 Memorial Parkway S.w., Huntsville, AL 35801 | 2019-02-21 |
| 1902373277 | Kelly S Fisher LLC | Counselor | 300 Clinton Avenue, Suite 22 A, Huntsville, AL 35801 | 2018-10-25 |
| 1073097911 | Brittani B Hamrick | Psychologist | 203 Eastside Sq Ste C9, Huntsville, AL 35801 | 2018-09-17 |
| 1548748312 | Jane O. Orton, Licsw, LLC | Social Worker | 120 Holmes Ave Ne, Huntsville, AL 35801 | 2018-08-02 |
| 1184100661 | Regroup Psychological Services | Psychologist | 2006 Franklin St. Se, Suite 110, Huntsville, AL 35801 | 2018-07-17 |
| 1366968398 | Bennett Brent Smith | Physician Assistant | 825 Adams St. Se, Huntsville, AL 35801 | 2017-08-22 |
| Find all providers in zip 35801 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548757420 | Dpi of Alabama LLC | Pain Medicine | 3310 Kelly Creek Rd, Moody, AL 35004 | 2018-04-17 |
| 1730313156 | Auburn Pain Specialists LLC | Pain Medicine | 890 North Dean Rd, Suite 100, Auburn, AL 36830 | 2009-05-13 |
| 1497989180 | Aaron T. Shinkle | Pain Medicine | 660 Mcqueen Smith Rd N Ste E, Prattville, AL 36066-7559 | 2009-05-08 |
| 1386791697 | Central Alabama Pain Management Center, P.C. | Pain Medicine | 1709 Forest Ave, Montgomery, AL 36106-1543 | 2007-01-05 |
| 1255393393 | Medha A Pradhan | Pain Medicine | 7205 Copperfield Dr, Montgomery, AL 36117-7101 | 2006-04-04 |
| 1447210844 | Painsouth Inc | Pain Medicine | 1528 Carraway Blvd, Suite 402, Birmingham, AL 35234 | 2006-03-28 |
| 1225098163 | Michael Scott Kendrick | Pain Medicine | 1020 26th St S, Suite 100, Birmingham, AL 35205-2412 | 2006-03-24 |
| 1467866624 | Pain Treatment Centers of Alabama, PC | Pain Medicine | 470 Taylor Rd, Suite 201, Montgomery, AL 36117-3563 | 2014-06-16 |
| 1467603670 | Jacob Anthony Vella | Pain Medicine | 488 Saint Lukes Dr, Montgomery, AL 36117 | 2008-10-07 |
| 1700044328 | Metro Anesthesia & Pain Services PC | Pain Medicine | 1340 Sledge Dr, Mobile, AL 36606-3021 | 2008-05-30 |
| Find all providers with the same taxonomy | ||||
| City | HUNTSVILLE |
| Zip Code | 35801 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.