OrganizationActive
Interventional Pain Center, PLLC
NPI 1790221612 · Pain Medicine (Anesthesiology) Physician · Henderson, NC
Provider details
- NPI number
- 1790221612
- Entity type
- Organization
- Primary specialty
- Pain Medicine (Anesthesiology) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Shaneka Tinch, Rcm Manager(469) 458-9222
- License
- 200100673 (NC)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(70/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
451 Ruin Creek Rd
Suite 103
Henderson, NC 27536-2878
Phone: (252) 438-3186
Fax: (252) 438-2602
Street-level locationGet directions
Mailing address
Po Box 931038
Atlanta, GA 31193-1038
Registry dates
- Enumerated
- 2017-01-17
- Last updated
- 2025-12-08
- Certified
- 2025-12-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.