SACKDINANH NOK KEOMAHATHAI (NPI# 1083775670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083775670 |
| Entity Type | Individual |
| Full Name | SACKDINANH NOK KEOMAHATHAI |
| Credential | MD |
| Practice Address |
110 Evans Mill Dr Ste 804-805 Dallas GA 30157-1622 |
| Mailing Address |
3390 Peachtree Rd Ne Ste 1500 Atlanta GA 30326-2822 |
| Practice Telephone | 7709299033 |
| Practice Fax Number | 7709299092 |
| Mailing Telephone | 7709299033 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-10-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | 051054 | GA | Allopathic & Osteopathic Physicians |
| N | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
051054 | GA | Allopathic & Osteopathic Physicians |
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
051054 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000937153A | 05 |
| Street Address |
110 EVANS MILL DR STE 804-805 |
| City | DALLAS |
| State | GA |
| Zip Code | 30157-1622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922608629 | Harshadbhai Vinubhai Patel | Pharmacist | 3615 Marietta Highway, Dallas, GA 30157 | 2020-10-30 |
| 1043852627 | Lindsay Sheets | Dentist | 59 Hillside Trce Ste 105, Dallas, GA 30157 | 2019-10-15 |
| 1619459062 | Emily Nicole Koopman | Specialist/Technologist | 399 Powder Creek Way, Dallas, GA 30157 | 2018-09-02 |
| 1073969861 | Rachel Spencer | Physical Therapist | 99 Hillside Trace, Dallas, GA 30157 | 2016-05-11 |
| 1336514827 | Petal Shields | Community Health Worker | 121 Omega Ct, Dallas, GA 30157 | 2015-12-09 |
| 1851797294 | Annette Moncion | Nurse Practitioner | 32 Midland Lane, Dallas, GA 30157 | 2014-11-12 |
| 1003211079 | Melissa Brice | Lactation Consultant, Non-RN | 430 Parson Rd, Dallas, GA 30157 | 2014-11-03 |
| 1104101690 | Jared Alan Lott | Pharmacist | 303 Charlie Watts Blvd, Dallas, GA 30157 | 2011-10-15 |
| 1972888758 | Lisa Nicole Mcentire | Massage Therapist | 119 Fairview Oak Trace, Dallas, GA 30157 | 2011-10-12 |
| 1548570120 | Chad Stough | Physician Assistant | 2713 Marietta Highway, Suite 122, Dallas, GA 30157 | 2010-10-15 |
| Find all providers in zip 30157 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326672866 | Arthritis Relief Institute | Pain Medicine | 12606 Greenville Ave Ste 195, Dallas, TX 75243-1909 | 2020-02-24 |
| 1528519410 | Pain Management Physicians of Dallas, Pllc. | Pain Medicine | 3430 W Wheatland Rd Ste 107, Dallas, TX 75237-3447 | 2016-10-17 |
| 1699121327 | Magnolia Pain Associates Pllc | Pain Medicine | 3801 Gaston Ave Ste 318- 320, Dallas, TX 75246 | 2016-05-12 |
| 1477939320 | Premier Pain Solutions Pllc | Pain Medicine | 320 Regal Row Ste 300, Dallas, TX 75247-5215 | 2015-08-03 |
| 1275960866 | Neo Services, LLC | Pain Medicine | 2110 Research Row # B100-g, Dallas, TX 75235-2519 | 2013-09-27 |
| 1437407525 | Center for Spine Interventions, PC | Pain Medicine | 2713 Charles Hardy Pkwy Ste 222, Dallas, GA 30157-9470 | 2012-08-21 |
| 1356615074 | Phoenix Pain Clinic, Pllc | Pain Medicine | 1110 N Buckner Blvd Ste 100, Dallas, TX 75218-3498 | 2012-02-27 |
| 1134336142 | Carl E Noe Md Pa | Pain Medicine | 3600 Gaston Ave Ste 360, Dallas, TX 75246-1903 | 2007-05-17 |
| 1487774717 | United Partners In Radiology | Pain Medicine | 9090 Skillman St Ste 182a, Pmb 371, Dallas, TX 75243-8278 | 2007-03-30 |
| 1902427107 | Pain Management Physicians of Dallas, Pllc | Pain Medicine | 10400 N Central Expy, Dallas, TX 75231-2297 | 2020-04-29 |
| Find all providers in DALLAS | ||||
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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.