Organization Active NPI

Spectrum Medical Solutions, LLC

Doing business as Spectrum Spine & Pain Care

  • Interventional Pain Medicine Physician
  • Pooler, GA
National Provider Identifier
1164958146
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
SPECTRUM MEDICAL SOLUTIONS, LLC
Doing business as
Spectrum Spine & Pain Care
Practice address
114 Canal St Ste 503
Pooler, GA 31322-4261
Phone
(912) 450-6300
Fax
(912) 450-6303
NPI assigned
May 11, 2017
Last updated
Mar 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Authorized official

Name
David Rowe, MDNPI 1629099304
Title
Physician/Owner
Phone
(912) 450-6300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X Primary

Addresses

Primary practice location

114 Canal St Ste 503
Pooler, GA 31322-4261

Mailing address

114 Canal St Ste 503
Pooler, GA 31322-4261

Other practice location 1

514 S Main St Ste C
Hinesville, GA 31313-4355
Phone (912) 450-6300

Other names 1

  • Spectrum Spine & Pain Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170829004474 GA Part B Supplier - Clinic/Group Practice 2860765658 Receives reassigned benefits from 5 practitioners
Practice locations: Hinesville, GA; Pooler, GA
O20180411000076 GA DME Supplier - Physician - Interventional Pain Management 2860765658 Practice locations: Pooler, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2136950Spectrum Medical Solutions114 Canal Street, Suite 503, Pooler, GA 31322Certificate of waiverMay 5, 2028
11D2183517Spectrum Medical Solutions514 S Main Streer Ste C, Hinesville, GA 31313Certificate of waiverMay 5, 2028

National Provider Directory

National Provider Directory

Locations

514 S Main St
Hinesville, GA 31313
Phone (912) 675-2829

514 S Main St
Ste 503
Hinesville, GA 31313

514 S Main St
Ste C
Hinesville, GA 31313
Phone (912) 450-6300

114 Canal St
Ste 503
Pooler, GA 31322
Phone (843) 310-1055

Practitioners & affiliated clinicians

Practitioners 5

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": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1164958146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 CANAL ST STE 503",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 CANAL ST STE 503",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224261",
            "telephone_number": "912-450-6300",
            "fax_number": "912-450-6303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "514 S Main St Ste C",
            "address_purpose": "LOCATION",
            "city": "Hinesville",
            "state": "GA",
            "postal_code": "313134355",
            "country_code": "US",
            "telephone_number": "912-450-6300",
            "fax_number": "912-450-6303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPECTRUM MEDICAL SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A",
        "authorized_official_last_name": "ROWE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "912-450-6300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spectrum Spine & Pain Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spectrum Spine & Pain Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.