MEDICARE: PROFESSIONAL PAIN MANAGEMENT, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	13528	TN

General Provider Information

NPI Number	:	1003109646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONAL PAIN MANAGEMENT, LLC

Provider Business Mailing Address
First Line	:	PO BOX 4350
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37320-4350
Country	:	US
Telephone Number	:	423-790-7500
Fax Number	:	423-790-5299

Provider Business Practice Location Address
First Line	:	301 KEITH ST SW
Second Line	:	SUITE 204
City	:	CLEVELAND
State	:	TN
Zip	:	37311-5808
Country	:	US
Telephone Number	:	423-790-7500
Fax Number	:	423-790-5299

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID S. COFER
Credential	:	NP
Telephone Number	:	423-790-7500

Provider Enumeration Date	:	05/16/2011
Last Update Date	:	05/16/2011

Similar Medicare Providers

1629070834 — MERRITT MEDICAL INC
Practice Location Address:

23293 COMMERCE PARK
CLEVELAND, OH
44122-5808

Practice Phone: 216-765-9005
Practice Fax: 216-765-9010

1376873422 — MS. MICHELLE LESLIE RENNERT MSW, LCSW
Practice Location Address:

3307 CLEVELAND LN
ROCKAWAY, NJ
07866-5808

Practice Phone: 973-784-3988
Practice Fax: 973-705-3862

1689424152 — BROOKE ELIZABETH BEELER MD
Practice Location Address:

5808 EUCLID AVE
CLEVELAND, OH
44103

Practice Phone: 216-844-3911
Practice Fax:

1205794724 — TAMMY LOUISE WILLIAMSON
Practice Location Address:

201 DOOLEY ST SE
CLEVELAND, TN
37311-6220

Practice Phone: 423-728-7020
Practice Fax:

1598623860 — JOSH ROBERT MARRIS GANN
Practice Location Address:

800 S LEE HWY
CLEVELAND, TN
37311-5853

Practice Phone: 423-506-8333
Practice Fax:

1962360032 — ROBIN SLUDER LPC
Practice Location Address:

2200 CHAMBLISS AVE NW
CLEVELAND, TN
37311-3874

Practice Phone: 423-599-9347
Practice Fax:

Directions to “PROFESSIONAL PAIN MANAGEMENT, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.