SPINE CENTER OF SOUTHEAST GEORGIA LLC (NPI# 1477106771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1477106771 |
Entity Type | Organization |
Organization Name | SPINE CENTER OF SOUTHEAST GEORGIA LLC |
Practice Address |
52a Lindsey Lane Kingsland GA 31548-6855 |
Practice Telephone | 9122626552 |
Practice Fax Number | 9122620112 |
Mailing Telephone | 9122626552 |
Mailing Fax Number | 9122620112 |
Enumeration Date | 2019-07-17 |
Last Update Date | 2019-08-26 |
Authorized Official Name | CHRISTOPHER JOHN BOVINET (OWNER) |
Authorized Official Telephone | 9122626552 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639270903 | Spine Center of Southeast Georgia LLC | Pain Medicine | 1111 Glynco Pkwy, Ste 300, Brunswick, GA 31525-7921 | 2006-09-26 |
Street Address |
52A LINDSEY LANE |
City | KINGSLAND |
State | GA |
Zip Code | 31548-6855 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356984611 | Shelby Nichole Gambill | Nurse Practitioner | 103 Lake Palms Dr, Kingsland, GA 31548 | 2019-10-18 |
1629536339 | The Behavior Placellc | Behavior Technician | 103 Johansen Way, Kingsland, GA 31548 | 2019-03-12 |
1588020234 | Keywanna Nichole Price | Nurse Practitioner | 571 Henrietta St, Kingsland, GA 31548 | 2016-01-11 |
1083086243 | Sorinity Support Services, LLC | Nurse's Aide | 801 Hwy 40 East Ste A-139, Kingsland, GA 31548 | 2015-10-28 |
1740661594 | Briana Gray | Family Medicine | 1375 E King Ave Ste B, Kingsland, GA 31548 | 2015-06-17 |
1649670530 | Kimberly Grande | Physical Therapist | 100 B Lindsey Lane, Kingsland, GA 31548 | 2014-08-27 |
1598044307 | Margaret Peek Powell | Counselor | 100 Mariners Dr. Suite D, Kingsland, GA 31548 | 2011-08-10 |
1376850545 | Heavenly Devine Blessing | Home Delivered Meals | 105 North Lee Street, Kingsland, GA 31548 | 2010-09-08 |
1053649657 | Melissa Anne White | Nurse Practitioner | 701 Charles Gilman Jr Ave Ste B, Kingsland, GA 31548 | 2009-11-20 |
1629203690 | Genevieve Matherne | Occupational Therapist | 100b Lindsey Lane, Kingsland, GA 31548 | 2009-05-20 |
Find all providers in zip 31548 |
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 |
---|---|---|---|---|
1356438824 | Georgia Pain Physicians PC | Pain Medicine | 88 Lindsey Ln, Ste B, Kingsland, GA 31548-6857 | 2006-10-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891302998 | Apollo Spine and Pain Center | Pain Medicine | 4415 Front Nine Dr, Cumming, GA 30041-6063 | 2020-09-23 |
1235756792 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 2100 Central Ave Ste 6, Augusta, GA 30904-6709 | 2020-07-01 |
1902433147 | Sun Pain Institute LLC | Pain Medicine | 836 E 65th St Ste 38, Savannah, GA 31405-4495 | 2020-03-26 |
1679107338 | Atlanta Interventional Pain Management, LLC | Pain Medicine | 13190 Highway 92 Ste 120, Woodstock, GA 30188-4406 | 2020-03-02 |
1578193355 | Regenerative Spine and Pain Specialists | Pain Medicine | 874 Lanier Ave W Ste 250, Fayetteville, GA 30214-7662 | 2020-01-22 |
1437790839 | Specialty Spine and Pain, PC | Pain Medicine | 1498 Jesse Jewell Pkwy Se Ste D, Gainesville, GA 30501-3874 | 2019-10-07 |
1154962165 | Specialty Spine and Pain, PC | Pain Medicine | 2695 Old Winder Hwy Ste 150, Braselton, GA 30517-6076 | 2019-10-01 |
1659912665 | Specialty Spine and Pain, PC | Pain Medicine | 5005a Lanier Islands Pkwy Ste 100, Buford, GA 30518-1802 | 2019-10-01 |
1114578515 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 6002 Highway 53 E Ste 110, Dawsonville, GA 30534-6227 | 2019-09-26 |
1467014936 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 6920 Mcginnis Ferry Rd Ste 360b, Suwanee, GA 30024-6672 | 2019-07-03 |
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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.