LAKESIDE PAIN CENTER, P.C.
NPI 1477566727
Pain Medicine - Interventional Pain Medicine in Bloomingdale, GA
NPI Status: Active since August 15, 2006
Contact Information
701 E US HIGHWAY 80 STE C
BLOOMINGDALE, GA
ZIP 31302
Phone: (478) 475-9220
Fax: (478) 475-9201
Some details in this NPI profile have been updated in the NPI registry within the last 30 days.
- Organization
- Pain Medicine
- Interventional Pain Medicine
- CLIA Number: 11D1085729
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 06-24-2026
About LAKESIDE PAIN CENTER, P.C.
This page provides the complete NPI Profile along with additional information for Lakeside Pain Center, P.c., a provider established in Bloomingdale, Georgia operating as a Pain Medicine, focusing in interventional pain medicine . The healthcare provider is registered in the NPI registry with number 1477566727 assigned on August 2006. The practitioner's primary taxonomy code is 208VP0014X with license number 042215 (GA). The provider is registered as an organization and their NPI record was last updated May 2026. Lakeside Pain Center, P.c. operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Dwayne Lee Clay (Md)
- NPI
- 1477566727
- Provider Name
- LAKESIDE PAIN CENTER, P.C.
- Entity Type
- Organization
- Location Address
- 701 E US HIGHWAY 80 STE C BLOOMINGDALE, GA 31302
- Location Phone
- (478) 475-9220
- Location Fax
- (478) 475-9201
- Mailing Address
- 701 E US HIGHWAY 80 STE C BLOOMINGDALE, GA 31302
- Mailing Phone
- (478) 475-9220
- Mailing Fax
- (478) 475-9201
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-15-2006
- Last Update Date
- 05-13-2026
- Code Navigator
Location Map
Secondary Locations
- 125 Plantation Centre Dr S Ste 750A
Macon, GA 31210
(478) 475-9220
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pain Medicine Interventional Pain Medicine
- Taxonomy Code
- 208VP0014X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 042215
- License State
- GA
- Taxonomy Description
- Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 042215 (GA) |
| 2 | 208VP0000X | Allopathic & Osteopathic Physicians | Pain Medicine | 042215 (GA) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D1085729
- Facility Type
- Physician Office
- Certificate Effective Date
- June 25, 2024
- Certificate Expiration Date
- June 24, 2026
- Laboratory Director
- DWAYNE L. CLAY
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Lakeside Pain Center, P.c. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1477566727, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 63 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1477566727, enumerated as an "organization" on August 15, 2006.
The provider is located at 701 E US HIGHWAY 80 STE C BLOOMINGDALE, GA 31302 and the phone number is (478) 475-9220.
Pain Medicine with taxonomy code 208VP0014X and a focus in Interventional Pain Medicine.
