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LAKESIDE PAIN CENTER, P.C.
NPI 1477566727
Pain Medicine - Interventional Pain Medicine in Bloomingdale, GA

Active since August 15, 2006CLIA 11D2336505 · Waiver
701 E US HIGHWAY 80 STE C, BLOOMINGDALE, GA 31302(478) 475-9220(478) 475-9201 Get Directions Write a Review

NPPES record last updated: May 13, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Lakeside Pain Center, P.c. NPPES

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

LAKESIDE PAIN CENTER, P.C. (NPI 1477566727) is a healthcare organization registered as an interventional pain medicine in Bloomingdale, Georgia and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through January 5, 2028, maintains a secondary practice location in Macon, and lists Dwayne Lee Clay, Md, as its authorized official.

NPPES Registry Identity

NPI1477566727
Entity TypeOrganization
Primary Taxonomy208VP0014X
Legal Business NameLAKESIDE PAIN CENTER, P.C.
Location Address701 E US HIGHWAY 80 STE CBloomingdale, GA 31302-0078
Mailing Address701 E Us Highway 80 Ste CBloomingdale, GA 31302-0078 · (478) 475-9220 · Fax (478) 475-9201
Phone(478) 475-9220
Fax(478) 475-9201
Organization SubpartNo
Authorized OfficialDwayne Lee ClayMd · (478) 475-9220
Enumeration DateAugust 15, 2006
Last NPPES UpdateMay 13, 2026
NPPES CertifiedMay 13, 2026
✔ NPI 1477566727 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0014X
License✔ Licensed in GA · 042215
Definition
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.
Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X · License 042215 (GA)
Also ListedPain Medicine · Pain MedicineTaxonomy 208VP0000X · License 042215 (GA)
701 E US HIGHWAY 80 STE C, Bloomingdale, GA 31302
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Secondary Practice Location 1

Location 1125 Plantation Centre Dr S Ste 750AMacon, GA 31210-2091 · Phone (478) 475-9220

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 of Waiver 11D2336505

Lakeside Pain Center, PC · Bloomingdale, GA
Active · expires Jan 5, 2028
CLIA Number11D2336505
Laboratory TypePhysician Office
Certificate Effective DateJanuary 6, 2026
Certificate Expiration DateJanuary 5, 2028
Laboratory DirectorDwayne L. Clay
Laboratory Phone(478) 475-9220
Laboratory LocationLakeside Pain Center, PC701 E Us Highway 80, Suite C, Bloomingdale, GA 31302
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Lakeside Pain Center, P.C.'s NPI number?

The NPI number for Lakeside Pain Center, P.C. is 1477566727. It was assigned to this organization in the NPPES registry on August 15, 2006.

Where is Lakeside Pain Center, P.C. located?

Lakeside Pain Center, P.C. is located at 701 E Us Highway 80 Ste C, Bloomingdale, GA 31302. The listed phone number is (478) 475-9220.

What is Lakeside Pain Center, P.C.'s specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Does Lakeside Pain Center, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2336505) is associated with this NPI, valid through January 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lakeside Pain Center, P.C. was last updated on May 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.