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PHYSICIAN ASSOCIATE INTERDISCIPLINARY CLINIC (PAIN-C)
NPI 1407373210
Physician Assistant in Memphis, TN

Active since August 23, 2017CLIA 44D2237014 · Microscopy
4131 KIRBY PKWY STE 1, KIRBY-RAINES MEDICAL CENTER, MEMPHIS, TN 38115(706) 536-3272 Get Directions Write a Review

NPPES record last updated: November 10, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 10, 2021, Jan 27, 2021, Apr 14, 2020 and 1 more (4 updates tracked since 2017).

About Physician Associate Interdisciplinary Clinic (pain-c) NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHYSICIAN ASSOCIATE INTERDISCIPLINARY CLINIC (PAIN-C) (NPI 1407373210) is a healthcare organization registered as a physician assistant in Memphis, Tennessee and active in the NPI registry since August 2017. The organization holds a CLIA Microscopy certificate valid through September 21, 2027 and lists Maurice Skillern, President / Ceo, as its authorized official.

NPPES Registry Identity

NPI1407373210
Entity TypeOrganization
Primary Taxonomy363A00000X
Legal Business NamePHYSICIAN ASSOCIATE INTERDISCIPLINARY CLINIC (PAIN-C)
Location Address4131 KIRBY PKWY STE 1, KIRBY-RAINES MEDICAL CENTERMemphis, TN 38115-3206
Mailing Address4131 Kirby Pkwy Ste 1Memphis, TN 38115-6500 · (706) 536-3272
Phone(706) 536-3272
Organization SubpartNo
Authorized OfficialMaurice SkillernPresident / Ceo · (706) 536-3272
Enumeration DateAugust 23, 2017
Last NPPES UpdateNovember 10, 20214 updates tracked since enumeration
NPPES CertifiedNovember 10, 2021
✔ NPI 1407373210 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TN · 1805
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
4131 KIRBY PKWY STE 1, Memphis, TN 38115
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Other Identifiers 1

Other1407373210Clinic Npi Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 44D2237014

Physician Associate Interdisciplinary Clinic · Memphis, TN
Active · expires Sep 21, 2027
CLIA Number44D2237014
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 22, 2025
Certificate Expiration DateSeptember 21, 2027
Laboratory DirectorMaurice Skillern
Laboratory Phone(901) 305-6766
Laboratory LocationPhysician Associate Interdisciplinary Clinic4131 Kirby Pkwy, Suite 1, Memphis, TN 38115
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MAURICE SKILLERN DMS-PA
Physician Assistant
4131 KIRBY PKWY STE 1
MEMPHIS, TN 38115
Shelby County (706) 536-3272
DR. TAMMY DELANEY DNP
Nurse Practitioner (Family)
4131 KIRBY PKWY STE 1
MEMPHIS, TN 38115
Shelby County (901) 304-5181
C & T HEALTHCARE SPECIALISTS, LLC
Clinic/Center (Health Service)
4131 KIRBY PKWY STE 1
MEMPHIS, TN 38115
Shelby County (901) 304-5181
TWYLA M TWILLIE MD
Internal Medicine
4131 KIRBY PKWY STE 1
MEMPHIS, TN 38115
Shelby County (901) 368-6883

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Physician Associate Interdisciplinary Clinic (pain-C)'s NPI number?

The NPI number for Physician Associate Interdisciplinary Clinic (pain-C) is 1407373210. It was assigned to this organization in the NPPES registry on August 23, 2017.

Where is Physician Associate Interdisciplinary Clinic (pain-C) located?

Physician Associate Interdisciplinary Clinic (pain-C) is located at 4131 Kirby Pkwy Ste 1 Kirby-Raines Medical Center, Memphis, TN 38115. The listed phone number is (706) 536-3272.

What is Physician Associate Interdisciplinary Clinic (pain-C)'s specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Does Physician Associate Interdisciplinary Clinic (pain-C) hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 44D2237014) is associated with this NPI, valid through September 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Physician Associate Interdisciplinary Clinic (pain-C) was last updated on November 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.