PAVANA TREATMENT GROUP P.C. NPI 1043849896

NPI Information

  • NPI: 1043849896
  • Provider Name: PAVANA TREATMENT GROUP, P.C.
  • Classification: Anesthesiology - 207LA0401X
  • Specialization: Addiction Medicine
  • Entity Type: Organization
  • CLIA Number: 34D2259976
  • Address: 1560 UNION RD
    GASTONIA, NC
    ZIP 28054
  • Phone: (704) 490-4993

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NPI Details

PAVANA TREATMENT GROUP, P.C. is an addiction medicine anesthesiology in Gastonia, NC. The provider is an anesthesiologist who specializes in the diagnosis and treatment of addictions. PAVANA TREATMENT GROUP, P.C. NPI is 1043849896. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1560 UNION RD
GASTONIA, NC
ZIP 28054-209
Phone: (704) 490-4993

The provider's authorized official is Melissa Blocker .
The authorized official title is Cfo and has the following contact phone number (864) 800-3223.

The CLIA number assigned to this NPI record is 34D2259976 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/3/2020 and was last updated on 8/13/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207LA0401XAnesthesiologyAddiction MedicineYes
2261QM1300XClinic/CenterMulti-SpecialtyNo
3261QR0405XClinic/CenterRehabilitation, Substance Use DisorderNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11043849896MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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