Pai Participant 11 PC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

Legal business name

PAI PARTICIPANT 11 PC

Practice address

415 Airport Rd
Griffin, GA 30224-4834

Phone

(770) 227-8636

NPI assigned

May 20, 2019

Last updated

Aug 13, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brittain Brantley

Title

Acting President

Phone

(302) 300-5138

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

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.

• Angella Samuels, DNP

  • Nurse Practitioner
  • Snellville, GA
  • NPI 1043406069
  Medicare reassignment NPD
• Erica Jaime Moret Willems, NP

  • Nurse Practitioner
  • Suwanee, GA
  • NPI 1255071379
  NPD (past)

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1144887720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639676",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639676",
            "telephone_number": "859-291-4800",
            "fax_number": "859-655-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 AIRPORT RD",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244834",
            "telephone_number": "770-227-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAI PARTICIPANT 11 PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-20",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "BRANTLEY",
        "authorized_official_first_name": "BRITTAIN",
        "authorized_official_title_or_position": "ACTING PRESIDENT",
        "authorized_official_telephone_number": "302-300-5138"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ehi Philip Osehobo, MD PHD
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• Maxine Owusu, M.D
• Haritha Pabbathi, MD
• Landon Pack, PT
• Pain Management Specialists of Atlanta P C
• Pain Management Specialists of Atlanta, PC
• Theofanis Pantazis, MS CCC-SLP
• Allison Danielle Parker, FNP
• Angela Parker

• Geriatric Medicine (Internal Medicine) Physician in Griffin, GA
• Providers in Griffin, GA by specialty
• Geriatric Medicine (Internal Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.