Sackdinanh Nok Keomahathai, MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

051054 Issued in GA

Practice address

650 Henderson Dr Ste 409
Cartersville, GA 30120-3758

Phone

(470) 274-2800

Fax

(800) 501-3088

NPI assigned

Dec 13, 2006

Last updated

Jun 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Interventional Pain Management

Education

Virginia Commonwealth University, School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Adventist Health System Georgia IncGroup PAC ID 4486568037, 247 clinicians

Interventional Pain Specialists of Georgia LLCGroup PAC ID 6709222730, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Coosa Valley Home Health, an Amedisys Home health agency, Rome, GA, CCN 117041
• Adventhealth Redmond Hospital, Rome, GA, CCN 110168
• Piedmont Cartersville Medical Center Hospital, Cartersville, GA, CCN 110030
• Adventhealth Gordon Hospital, Calhoun, GA, CCN 110023
• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
• Redmond Regional Medical Center Inpatient rehabilitation facility, Rome, GA, CCN 11T168
• Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sackdinanh.keomahathai.p3@direct.precisionspinecare.nextgenshare.com
• Direct secure messaging: sackdinanh.keomahathai.p1@direct.aicaorthopedics.nextgenshare.com
• Direct secure messaging: sackdinanh.nokkeomahathai.p3@direct.aicaorthopedics.nextgenshare.com
• Direct secure messaging: sackdinanh.keomahathai.p2@direct.aicaorthopedics.nextgenshare.com
• Direct secure messaging: interventionalpainspecialistofga.nokkeomahathai@157503.advancedmd-direct.com
• Direct secure messaging: sackdinanh.nokkeomahathai.p6@direct.aicaorthopedics.nextgenshare.com

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

• Interventional Pain Specialists of Georgia LLC

  • Interventional Pain Medicine Physician
  • Cartersville, GA
  • NPI 1205698396
  Medicare reassignment Care Compare group NPD Authorized official
• Adventist Health System Georgia Inc

  dba AdventHealth Medical Group

  • Multi-Specialty Clinic/Center
  • Calhoun, GA
  • NPI 1699791343
  Medicare reassignment Care Compare group NPD
• The Interventional Spine and Pain Management Center, PC

  dba Alliance Spine and Pain Centers

  • Interventional Pain Medicine Physician
  • Conyers, GA
  • NPI 1518012004
  Medicare reassignment NPD
• Georgia Pain Institute. LLC

  dba Pain Institute of Georgia

  • Pain Medicine Physician
  • Macon, GA
  • NPI 1265560379

  Interventional Pain Medicine

  NPD
• The Interventional Spine and Pain Management Center PC

  dba Alliance Spine and Pain Centers

  • Interventional Pain Medicine Physician
  • Cumming, GA
  • NPI 1447963608
  NPD
• Aica Orthopedics, P. C.

  • Clinic/Center
  • Conyers, GA
  • NPI 1689257388
  NPD (past)

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

• Adventist Health System Georgia, Inc.

  dba AdventHealth Gordon

  • General Acute Care Hospital
  • Calhoun, GA
  • NPI 1760402424
  Care Compare affiliation
• Amedisys Georgia, L.L.C.

  dba Coosa Valley Home Health, an Amedisys Company

  • Home Health Agency
  • Rome, GA
  • NPI 1285682955
  Care Compare affiliation
• Cartersville Medical Center LLC

  dba Cartersville Medical Center

  • General Acute Care Hospital
  • Cartersville, GA
  • NPI 1780638833
  Care Compare affiliation
• Kennestone Hospital, Inc.

  dba Wellstar Kennestone Hospital

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  Care Compare affiliation
• Kennestone Hospital, Inc.

  dba Wellstar Windy Hill Hospital

  • Long Term Care Hospital
  • Marietta, GA
  • NPI 1700853041

  Long-term care hospital

  Care Compare affiliation
• Redmond Park Hospital, LLC

  dba Adventhealth Redmond

  • General Acute Care Hospital
  • Rome, GA
  • NPI 1508810565
  Care Compare affiliation
• Redmond Park Hospital, LLC

  dba Adventhealth Redmond

  • Rehabilitation Hospital Unit
  • Rome, GA
  • NPI 1548214257

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1083775670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 HENDERSON DR STE 409",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301203758",
            "telephone_number": "470-274-2800",
            "fax_number": "800-501-3088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 HENDERSON DR STE 409",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301203758",
            "telephone_number": "470-274-2800",
            "fax_number": "800-501-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOMAHATHAI",
        "first_name": "SACKDINANH",
        "middle_name": "NOK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "051054",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "GA",
            "license": "051054",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "051054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ralph Keene Jr., PHD
• Nancy Kelly, LPC
• Jordan Kemme, MD
• Staci N Kenner, M.D.
• Kennestone Heart Physicians Group, PC
• Samuel Key, MD
• Michelle Khajavi, MS
• Amna Khan, LMSW
• Kidsz Paradise Inc.
• Kim Bondurant MD PC

• Interventional Pain Medicine Physician in Cartersville, GA
• Providers in Cartersville, GA by specialty
• Interventional Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.