GEORGIA SPINE AND BRAIN, PC (NPI# 1306876198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306876198 |
| Entity Type | Organization |
| Organization Name | GEORGIA SPINE AND BRAIN, PC |
| Practice Address |
1676 Mulkey Rd Suite A Austell GA 30106-1170 |
| Practice Telephone | 6788386600 |
| Practice Fax Number | 6788386602 |
| Mailing Telephone | 6788386600 |
| Mailing Fax Number | 6788386602 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | OMAR JIMENEZ (OWNER) |
| Authorized Official Telephone | 6788386600 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | MEDICARE GRP ID | GRP4690 | 01 |
| Street Address |
1676 MULKEY RD SUITE A |
| City | AUSTELL |
| State | GA |
| Zip Code | 30106-1170 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649419557 | Jennifer L Mcclure | Specialist/Technologist, Other | 1676 Mulkey Rd, Ste A, Austell, GA 30106-1170 | 2009-02-17 |
| 1275772352 | Advanced Audiology Hearing Aid Center Inc | Audiologist | 1676 Mulkey Rd, Suite 100, Austell, GA 30106-1170 | 2009-02-12 |
| 1215176607 | Shannon M Beaulieu | Specialist/Technologist, Other | 1676 Mulkey Rd, Ste A, Austell, GA 30106-1170 | 2009-02-10 |
| 1760665715 | Michael A Acree | Specialist/Technologist, Other | 1676 Mulkey Rd, Suite A, Austell, GA 30106-1170 | 2007-12-13 |
| 1023210895 | Manuel Piri | Nurse Practitioner | 1676 Mulkey Rd, Suite A, Austell, GA 30106-1170 | 2007-06-04 |
| 1568676013 | Whitney Prince | Specialist/Technologist, Other | 1676 Mulkey Rd, Suite A, Austell, GA 30106-1170 | 2007-05-10 |
| 1467522136 | Richard Ralph Kaiser | Pediatrics | 1676 Mulkey Rd, Suite C, Austell, GA 30106-1170 | 2006-11-09 |
| 1427128107 | John C Warner Jr. | Pediatrics | 1676 Mulkey Rd, Suite C, Austell, GA 30106-1170 | 2006-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126231 | Courtney Lashune Dorsett | Nurse Practitioner | 1005 Cureton Drive, Austell, Austell, GA 30106 | 2020-08-27 |
| 1184240491 | Brian H Eves | Dietitian, Registered | 3972 Brantley Drive, Austell, GA 30106 | 2020-06-23 |
| 1669014486 | Jesse Mccoy | Registered Nurse | 3950 Austell Rd., Austell, GA 30106 | 2019-10-14 |
| 1427522820 | Envision Optics LLC | Optometrist | 1680 E West Connector, Austell, GA 30106 | 2019-01-18 |
| 1972042380 | Thomas Dental Group | Clinic/Center | 1133 East West Connector, Suite 120, Austell, GA 30106 | 2017-02-17 |
| 1245779792 | Colton Dental Group | Clinic/Center | 2495 East-west Connector, Ste 60, Austell, GA 30106 | 2017-02-16 |
| 1144691684 | Georgia Dental Professionals, PC | Dentist | 780 East West Connector Sw, Suite 108, Austell, GA 30106 | 2015-10-09 |
| 1285013714 | Ikeade Bello Alamu | Nurse Practitioner | 2870 Betula Drive, Austell, GA 30106 | 2015-05-29 |
| 1376922211 | Jessica Williams | Obstetrics & Gynecology | 1700 Hospital South Dr Ste 500, Austell, GA 30106 | 2015-05-26 |
| 1558799593 | Tonya Renee Baldwin | Speech-Language Pathologist | 4229 Brass Trl., Austell, GA 30106 | 2013-10-30 |
| Find all providers in zip 30106 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003179425 | Marcus J Gates | Neurological Surgery | 1700 Hospital South Dr Ste 102, Austell, GA 30106-8116 | 2012-06-20 |
| 1265605091 | Dare Alabi Adewumi | Neurological Surgery | 1605 Mulkey Rd Ste A, Austell, GA 30106 | 2008-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275505 | Apex Spine and Neurosurgery LLC | Neurological Surgery | 1295 Hembree Rd Ste 200 Bldg B, Roswell, GA 30076 | 2020-11-06 |
| 1457968372 | Reagan Medical Center | Neurological Surgery | 1295 Hembree Rd Ste 200, Roswell, GA 30076-5721 | 2020-09-24 |
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1831720408 | Jonathan Lau | Neurological Surgery | 1365 Clifton Rd Ne Ste B6168, Atlanta, GA 30322-1013 | 2020-01-31 |
| 1528612728 | The Neurological Institute of Savannah & Center for Spine, PC | Neurological Surgery | 101 St Josephs Candler Dr, Pooler, GA 31322-9579 | 2019-07-26 |
| 1770149478 | The Neurological Institute of Savannah & Center for Spine P C | Neurological Surgery | 2a Ed Moore Ct, Statesboro, GA 30458-5024 | 2019-05-17 |
| 1740758358 | Allspine Surgery Center-2 LLC | Neurological Surgery | 1944 Clairmont Rd, Decatur, GA 30033-3406 | 2018-11-13 |
| 1427531268 | Robert Burney II | Neurological Surgery | 101 Lakeview Dr, Hamilton, GA 31811-4365 | 2018-09-07 |
| 1558878884 | Tattnall Hospital Company, LLC | Neurological Surgery | 242 Industrial Blvd, Dublin, GA 31021 | 2018-01-09 |
| 1942727425 | The Neurological Institute of Savannah & Center for Spine P C | Neurological Surgery | 1805 Manning Dr, Vidalia, GA 30474-8921 | 2017-08-25 |
| 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.