Healthcare Provider Details

I. General information

NPI: 1942547120
Provider Name (Legal Business Name): CAROLINAS PAIN INSTITUTE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2013
Last Update Date: 04/24/2020
Certification Date: 04/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 N FAYETTEVILLE ST SUITE 106
ASHEBORO NC
27203-4670
US

IV. Provider business mailing address

PO BOX 896125
CHARLOTTE NC
28289-6125
US

V. Phone/Fax

Practice location:
  • Phone: 336-610-7246
  • Fax:
Mailing address:
  • Phone: 336-765-6181
  • Fax: 336-765-8492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number StateNC

VIII. Authorized Official

Name: DR. JAMES M NORTH
Title or Position: MD
Credential: MD
Phone: 336-765-6181