NPIMap

Organization Active NPI

Georgia Spine Specialists

  • Specialist
  • Smyrna, GA
National Provider Identifier
1013206952
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
52966 Issued in GA
Legal business name
GEORGIA SPINE SPECIALISTS
Practice address
3903 S Cobb Dr SE
Ste 105
Smyrna, GA 30080-8504
Phone
(678) 838-6600
Fax
(770) 438-1477
NPI assigned
Mar 31, 2011
Last updated
Mar 31, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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

Authorized official

Name
Dr. Miguel A Jimenez, MDNPI 1649204751
Title
Ceo
Phone
(770) 374-3714

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 52966 GA Primary

Addresses

Primary practice location

3903 S Cobb Dr SE
Ste 105
Smyrna, GA 30080-8504

Mailing address

11 Maybelle St
Cartersville, GA 30120-3615
Phone (770) 334-2065

National Provider Directory

National Provider Directory
Tax ID family
Georgia Spine Specialists3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301529600000",
    "number": "1013206952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MAYBELLE ST",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301203615",
            "telephone_number": "770-334-2065",
            "fax_number": "770-334-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 S COBB DR SE",
            "address_2": "STE 105",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808504",
            "telephone_number": "678-838-6600",
            "fax_number": "770-438-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA SPINE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-31",
        "last_updated": "2011-03-31",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-374-3714",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "52966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.