SOUTH DEKALB SPINAL CENTER, LLC (NPI# 1033475140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033475140 |
| Entity Type | Organization |
| Organization Name | SOUTH DEKALB SPINAL CENTER, LLC |
| Practice Address |
4480 Covington Hwy Suite A Decatur GA 30035-1218 |
| Practice Telephone | 4042845556 |
| Practice Fax Number | 4042845557 |
| Mailing Telephone | 4042845556 |
| Mailing Fax Number | 4042845557 |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2012-04-03 |
| Authorized Official Name | MARIA PARGA (OFFICE MANAGER) |
| Authorized Official Telephone | 4042845556 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities |
| Street Address |
4480 COVINGTON HWY SUITE A |
| City | DECATUR |
| State | GA |
| Zip Code | 30035-1218 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720247265 | Frank Ojo Dania | Family Medicine | 4480 Covington Hwy, Suite B, Decatur, GA 30035-1218 | 2008-06-09 |
| 1588892293 | Covington Clinic PC | Clinic/Center | 4480 Covington Hwy, Suite B, Decatur, GA 30035-1218 | 2009-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972079978 | James L Vinson, Phd | Home Health Aide | 4050 Snapfinger Woods Drive, Suite 201, Decatur, GA 30035 | 2018-10-17 |
| 1417445206 | Kamla Gonzales | Nurse Practitioner | 5146 Miller Woods Trl, Decatur, GA 30035 | 2018-04-26 |
| 1578924924 | Alicia Marie Johnson Bryant | Social Worker | 5878 Covington Hwy, Decater, GA 30035 | 2016-03-14 |
| 1568865756 | Tracy Roberson | Counselor | 4150 Snapfinger Woods Drive, Decatur, GA 30035 | 2014-10-01 |
| 1972927861 | Tyrone D. Lane Enterprises, Incorporated | Psychologist | 5304 Panola Industrial Boulevard, Suite L, Decatur, GA 30035 | 2014-02-12 |
| 1013255355 | Mervin E Williams | Pharmacist | 2075 South Hairston, Decatur, GA 30035 | 2013-01-22 |
| 1205187572 | Mariana Simpson-walker | Speech-Language Pathologist | 4262 Clausell Ct Ste A, Decatur, GA 30035 | 2012-09-27 |
| 1053683854 | Jimiesh G Crane | Dentist | 5243 Snapfinger Woods Dr Ste 105, Decatur, GA 30035 | 2012-02-08 |
| 1568765824 | Salih Robinson | Health Educator | 2511 Lantrac Ct, Decatur, GA 30035 | 2010-12-08 |
| 1831428234 | Thomas Counseling | Counselor | 3781 Presidential Parkway, Suite 111c, Chamblee, GA 30035 | 2009-12-14 |
| Find all providers in zip 30035 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043537905 | Primacare Pain & Rehab.,llc | Clinic/Center | 4467 Glenwood Rd, Suite 2, Decatur, GA 30032-5014 | 2010-04-30 |
| 1902261274 | Complete Health Medical Center | Clinic/Center | 4153 Flat Shoals Pkwy, Bldg A Ste 104, Decatur, GA 30034-4106 | 2015-12-30 |
| 1437525557 | North Alabama Pain Services | Clinic/Center | 1852 Beltline Rd Sw, Decatur, AL 35601-5518 | 2015-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558970640 | Fx Spine and Performance Center, LLC | Clinic/Center | 106 Srp Dr Ste B, Evans, GA 30809-4358 | 2020-07-24 |
| 1083253140 | Intercare Medical, Corp | Clinic/Center | 3540 Wheeler Rd Ste 307, Augusta, GA 30909-1887 | 2020-01-06 |
| 1346763190 | Laser Spine & Pain Centers LLC | Clinic/Center | 403 Permian Way Ste C, Villa Rica, GA 30180-3252 | 2017-07-24 |
| 1164828976 | Atlanta Pain and Wellness Center PC | Clinic/Center | 1287 Ga Hwy 138 Spur Ste 8, Jonesboro, GA 30236-2419 | 2014-11-06 |
| 1790031664 | Nr Medical Center, LLC | Clinic/Center | 213 Arrowhead Blvd, Suite D, Jonesboro, GA 30236-1168 | 2012-07-30 |
| 1740566181 | Physical Medicine of Norcross | Clinic/Center | 6315 Spaulding Dr Ste B, Norcross, GA 30092-4653 | 2011-10-31 |
| 1407131899 | Cambridge Labs,llc | Clinic/Center | 611 15th St, Augusta, GA 30901-2601 | 2011-10-17 |
| 1194994244 | Ernie E Lin | Clinic/Center | 211 Pleasant Home Road, Suite F-3, Augusta, GA 30907-0559 | 2008-02-22 |
| 1235354218 | Acworth Pain Management Center Inc | Clinic/Center | 5399 Bells Ferry Rd, Suite 180, Acworth, GA 30102-7546 | 2007-04-16 |
| 1487878856 | Suwanee Pain Management Center Inc | Clinic/Center | 415 Peachtree Industrial Blvd, Suite 600, Suwanee, GA 30024-6710 | 2007-04-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.