MEDICARE: LIV SPECIALTY CARE PA, PC

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	208VP0014X	Interventional Pain Medicine Physician

General Provider Information

NPI Number	:	1548113079
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIV SPECIALTY CARE PA, PC

Provider Business Mailing Address
First Line	:	4900 CENTENNIAL BLVD STE 300
Second Line	:	BOX 104
City	:	NASHVILLE
State	:	TN
Zip	:	37209-1105
Country	:	US
Telephone Number	:	844-509-1404
Fax Number	:	844-278-8635

Provider Business Practice Location Address
First Line	:	4900 CENTENNIAL BLVD STE 300
Second Line	:	BOX 104
City	:	NASHVILLE
State	:	TN
Zip	:	37209-1105
Country	:	US
Telephone Number	:	844-509-1404
Fax Number	:	844-278-8635

Authorized Official
Title or Position	:	CEO
Name	:	WOODRUFF BAUM
Credential	:
Telephone Number	:	646-568-0193

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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