Healthcare Provider Details

I. General information

NPI: 1770516080
Provider Name (Legal Business Name): PAIN MEDICINE & REHABILITATION GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 WILLIAMSON CT
BRENTWOOD TN
37027-8164
US

IV. Provider business mailing address

PO BOX 415000 MSC 410847
NASHVILLE TN
37241-0847
US

V. Phone/Fax

Practice location:
  • Phone: 615-331-5536
  • Fax: 888-491-9394
Mailing address:
  • Phone: 615-331-5536
  • Fax: 888-491-9394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number30672
License Number StateTN

VIII. Authorized Official

Name: DR. JOHN C NWOFIA
Title or Position: MEDICAL DIRECTOR
Credential: M.D
Phone: 615-331-5536