GOLDEN ISLES PAIN-MD, LLC (NPI# 1932387446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932387446 |
| Entity Type | Organization |
| Organization Name | GOLDEN ISLES PAIN-MD, LLC |
| Other Organization Name | PAIN - MD |
| Practice Address |
1111 Glynco Pkwy Ste 400 Brunswick GA 31525-7921 |
| Practice Telephone | 9122651357 |
| Practice Fax Number | 9122643405 |
| Mailing Telephone | 9122651357 |
| Mailing Fax Number | 9122643405 |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2008-02-06 |
| Authorized Official Name | MR. CARL TYLER SHENKMAN (PRESIDENT) |
| Authorized Official Telephone | 9122651357 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
036000 | GA | Allopathic & Osteopathic Physicians |
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
036000 | GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PAIN - MD | Doing Business As Name - Organization |
| Street Address |
1111 GLYNCO PKWY STE 400 |
| City | BRUNSWICK |
| State | GA |
| Zip Code | 31525-7921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922089713 | Northwest Diagnostic Imaging, Inc | Radiology | 1111 Glynco Pkwy, Brunswick, GA 31525-7921 | 2005-11-08 |
| 1639562978 | Tattnall Hospital Company, LLC | Orthopaedic Surgery | 1111 Glynco Pkwy, Suite 30 - A Summit Professional Plaza I, Brunswick, GA 31525-7921 | 2015-03-11 |
| 1487047726 | Optim Orthopedics, LLC | Orthopaedic Surgery | 1111 Glynco Pkwy, Suite 30 - A Summit Professional Plaza I, Brunswick, GA 31525-7921 | 2015-03-11 |
| 1376960179 | Joseph Durant | Specialist | 1111 Glynco Pkwy, Ste. 400, Brunswick, GA 31525-7921 | 2014-03-19 |
| 1760815880 | Kendra Curry | Social Worker | 1111 Glynco Pkwy, Bldg 2, Suite 200, Brunswick, GA 31525-7921 | 2013-08-12 |
| 1144575168 | Karah Lynn Brown | Physician Assistant | 1111 Glynco Pkwy, #2-100, Brunswick, GA 31525-7921 | 2012-07-16 |
| 1659643955 | Costrini & Meadows PC | Internal Medicine | 1111 Glynco Pkwy, Suite 410, Brunswick, GA 31525-7921 | 2012-02-01 |
| 1285917401 | Micah Henderson Lancaster | Physician Assistant | 1111 Glynco Pkwy, Building 1, Suite 20, Brunswick, GA 31525-7921 | 2011-09-23 |
| 1114215498 | Florida Bracing Centers, Inc. | Prosthetic/Orthotic Supplier | 1111 Glynco Pkwy, Building 2, Suite 110, Brunswick, GA 31525-7921 | 2011-07-20 |
| 1801105275 | Dublin Vamc | Clinic/Center | 1111 Glynco Pkwy, Summit Professional Plaza, Suite 200, Brunswick, GA 31525-7921 | 2010-10-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063905990 | Jonathon Wesley Capps | Physician Assistant | 1111 Glynco Pkwy Bldg 1, Ste 10, Brunswick, GA 31525 | 2018-06-14 |
| 1366993628 | Hands Down Muscle Restoration, Inc | Homeopath | 1212 Chapel Crossing Road, Brunswick, GA 31525 | 2016-10-20 |
| 1619424173 | Jebediah S Christy Dds - Brunswick Pllc | Dentist | 11455 Canal Crossing, Brunswick, GA 31525 | 2016-09-01 |
| 1831545508 | Heller Family Medicine, LLC | General Practice | 208 Scranton Connector Ste 120, Brunswick, GA 31525 | 2016-05-11 |
| 1437525391 | Natisha Danielle Hill | Occupational Therapy Assistant | 138 Wingefield Commons Drive, Brunswick, GA 31525 | 2015-08-14 |
| 1811269632 | Solar Family Practice | Family Medicine | 122 Scranton Connector, Suite 112, Brunswick, GA 31525 | 2012-02-09 |
| 1700187895 | Chetan Patel | Pharmacist | 12 Woodfall Ct, Brunswick, GA 31525 | 2010-11-05 |
| 1194914275 | Dialysis of Golden Isles, LLC | Clinic/Center | 475 Gateway Center Blvd, Brunswick, GA 31525 | 2007-10-15 |
| 1902939325 | Gateway Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Frazier Street, Brunswick, GA 31525 | 2007-03-14 |
| 1609909498 | Gateway Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 115 Frazier Road, Brunswick, GA 31525 | 2007-03-13 |
| Find all providers in zip 31525 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548536022 | Denice Starley, Do, LLC | Physical Medicine & Rehabilitation | 256 Scranton Connector Ste 112, Brunswick, GA 31525-0557 | 2012-03-28 |
| 1447490776 | Christopher John Bovinet | Physical Medicine & Rehabilitation | 1111 Glynco Pkwy Ste 300, Brunswick, GA 31525-7933 | 2009-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700490091 | Interventional and Alternative Spine and Wellness, LLC | Physical Medicine & Rehabilitation | 3630 Wheeler Rd, Augusta, GA 30909-6561 | 2020-09-03 |
| 1881205151 | Georgia Regenrx, LLC. | Physical Medicine & Rehabilitation | 5755 N Point Pkwy Ste 72, Alpharetta, GA 30022-1146 | 2020-08-11 |
| 1710514989 | Jennifer Meyer | Physical Medicine & Rehabilitation | 1554 Riverstone Pkwy Ste 160, Canton, GA 30114-2887 | 2020-03-26 |
| 1982172060 | Back To Life Pain Center, LLC | Physical Medicine & Rehabilitation | 410 Creekstone Rdg, Woodstock, GA 30188-3740 | 2018-11-07 |
| 1760900708 | Neuro Diagnostic Group LLC | Physical Medicine & Rehabilitation | 200 Galleria Pkwy Se Ste 100, Atlanta, GA 30339-5944 | 2017-08-30 |
| 1386195378 | Pain Management and Rehabilitation | Physical Medicine & Rehabilitation | 4121 Steve Reynolds Blvd, Norcross, GA 30093-3060 | 2016-10-14 |
| 1124471172 | Pain Management and Rehabilitation | Physical Medicine & Rehabilitation | 4131 Steve Reynolds Blvd, Norcross, GA 30093-3060 | 2016-07-14 |
| 1043671761 | Pain Management and Rehabilitation Inc | Physical Medicine & Rehabilitation | 3955 Lawrenceville Hwy Nw, Lilburn, GA 30047-2996 | 2016-03-08 |
| 1356761191 | Simon Matt Willis | Physical Medicine & Rehabilitation | 114 Canal St Ste 503, Pooler, GA 31322-4261 | 2014-04-20 |
| 1891139663 | Advanced Pain and Rahabilitation PC | Physical Medicine & Rehabilitation | 3030 Mcever Rd Ste 300, Gainesville, GA 30504-5538 | 2013-04-24 |
| 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.