Individual provider Active NPI

William Paul Ives, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Snellville, GA
National Provider Identifier
1003891300
Registry record updated Nov 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
044757 Issued in GA
Practice address
1976 Main St E
Suite C
Snellville, GA 30078-6460
Phone
(770) 982-2099
Fax
(770) 982-9045
NPI assigned
Dec 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 044757 GA Primary
Anesthesiology Physician 207L00000X 44757 GA

Addresses

Primary practice location

1976 Main St E
Suite C
Snellville, GA 30078-6460

Mailing address

285 Helens Manor Dr
Lawrenceville, GA 30045-3469
Phone (678) 377-9326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040720000712 GA Practitioner - AnesthesiologyPractitioner - Interventional Pain ManagementPractitioner - Pain Management 7214916600 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
University of Oklahoma College of Medicine, 1987
Medicare assignment
May accept Medicare assignment
Group practices
Premier Anesthesia of Georgia LLCGroup PAC ID 6608123724, 62 clinicians

Practice addresses (Care Compare)

1700 Medical Way
Snellville, GA 30078-2195
Phone (770) 979-0200

Hospital & facility affiliations

  • Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
44757GAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coffee Regional Medical Center, Inc CurrentSince Jul 29, 2015 Accepting new patients
Premier Anesthesia of Georgia LLC Anesthesiology CurrentSince Nov 1, 2022 Accepting new patients
Coffee Regional Medical Center, Inc Anesthesiology Current Accepting new patients
Coffee Regional Medical Center, Inc CurrentSince Jul 29, 2015 Accepting new patients
Northwest Allied Anesthesia Inc Past Accepting new patients
Southeastern Pain Specialists, P.C. Pain Medicine Past Accepting new patients

Locations

1101 Ocilla Rd
Douglas, GA 31533
Phone (912) 383-5641

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

2160 Fountain Dr
Snellville, GA 30078
Phone (770) 982-1111

1700 Medical Way
Snellville, GA 30078
Phone (770) 978-4229

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1003891300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 HELENS MANOR DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300453469",
            "telephone_number": "678-377-9326",
            "fax_number": "678-377-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1976 MAIN ST E",
            "address_2": "SUITE C",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786460",
            "telephone_number": "770-982-2099",
            "fax_number": "770-982-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVES",
        "first_name": "WILLIAM",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "GA",
            "license": "044757",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "44757",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.