ADVANCED SPINE & PAIN INTERVENTIONS LLC - JASPER (NPI# 1992292973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992292973 |
| Entity Type | Organization |
| Organization Name | ADVANCED SPINE & PAIN INTERVENTIONS LLC - JASPER |
| Practice Address |
620 J L White Drive Suite 140 Jasper GA 30143 |
| Mailing Address |
12389 Crabapple Rd Alpharetta GA 30004-6328 |
| Practice Telephone | 4702991998 |
| Practice Fax Number | 4702991898 |
| Mailing Telephone | 4702991998 |
| Mailing Fax Number | 4702991898 |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2018-04-16 |
| Authorized Official Name | WOODLEY MARDY-DAVIS (MEDICAL DIRECTOER) |
| Authorized Official Telephone | 4702991998 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | ADVANCED SPINE & PAIN INTERVENTIONS LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207LA0401X |
Anesthesiology Specialization: Addiction Medicine |
059463 | GA | Allopathic & Osteopathic Physicians |
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE010161 | GA | Suppliers |
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
059463 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 6004576980 | 05 |
| Street Address |
620 J L WHITE DRIVE SUITE 140 |
| City | JASPER |
| State | GA |
| Zip Code | 30143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073111845 | George Mackel, Pmhnp-bc, LLC | Nurse Practitioner | 12034 Big Canoe, 400 Shetland Trace, Jasper, GA 30143 | 2020-10-14 |
| 1598363434 | Amanda J Griggs | Massage Therapist | 54 Wolfscratch Village, Jasper, GA 30143 | 2020-10-13 |
| 1801397724 | Jema Day | Nurse Practitioner | 620 J L White Dr Ste 140, Jasper, GA 30143 | 2018-02-26 |
| 1023467545 | North Georgia Personal Care LLC | Home Health | 501 North Main St., Suite B, Jasper, GA 30143 | 2016-06-06 |
| 1871979641 | Sj & J Spine and Pain Group Holding LLC | Pain Medicine | 91 Sammy Mcghee Blvd, Suite 101, Jasper, GA 30143 | 2015-08-04 |
| 1801294293 | Highland Recovery Center | Community/Behavioral Health | 323 Roland Road, Jasper, GA 30143 | 2014-12-17 |
| 1770905861 | Leslie Rhea Hanagan | Speech-Language Pathologist | 22 Dogwood Lane, Jaser, GA 30143 | 2014-01-09 |
| 1669800660 | Pickens County Chiropractic | Chiropractor | 95 North Main Street, Jasper, GA 30143 | 2013-10-29 |
| 1407139264 | Rocky Mountain Holdings LLC | Ambulance | 70 Airport Business Court, Jasper, GA 30143 | 2011-09-27 |
| 1851681415 | Richard J Vandam | Internal Medicine | 1266 Highway 515, Piedmont Mountainside Hospital, Jasper, GA 30143 | 2011-04-15 |
| Find all providers in zip 30143 | ||||
| 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 |
|---|---|---|---|---|
| 1972959609 | Interventional Spine & Pain Management Center, PC | Pain Medicine | 620 J L White Dr, Suite 140, Jasper, GA 30143-4896 | 2016-05-12 |
| 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 |
| 1477106771 | Spine Center of Southeast Georgia LLC | Pain Medicine | 52a Lindsey Lane, Kingsland, GA 31548-6855 | 2019-07-17 |
| 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.