Spine Center Atlanta East, LLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

Legal business name

SPINE CENTER ATLANTA EAST, LLC

Practice address

1309 Wellbrook Cir.
Ste H
Conyers, GA 30012-3873

Phone

(678) 263-2020

Fax

(678) 608-3217

NPI assigned

Oct 4, 2016

Organization subpart

No

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

Authorized official

Name

Steven Weidler

Title

Chief Operating Officer

Phone

(404) 351-5812

Specialties & licenses 3

Addresses

Other names 1

• Spine Center Conyers,LLC Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dionna Squires John

  • Massage Therapist
  • Conyers, GA
  • NPI 1730680190
  NPD (past)

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544745600000",
    "number": "1194274001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3161 HOWELL MILL RD NW",
            "address_2": "STE 310",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303272132",
            "telephone_number": "404-351-5812",
            "fax_number": "678-608-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 WELLBROOK CIR.",
            "address_2": "STE H",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123873",
            "telephone_number": "678-263-2020",
            "fax_number": "678-608-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE CENTER ATLANTA EAST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-04",
        "last_updated": "2018-12-14",
        "status": "A",
        "authorized_official_last_name": "WEIDLER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "404-351-5812"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spine Center Conyers,LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Paula M. Spence, PMHNP-BC
• Delores Yvonne Spencer-Izegbu, E.D.
• Claudette R Spencer, EDD
• Margaret Spencer, D.C.
• Erica Ann Sperduto, FNP
• Asa Spurlock
• Dionna Squires John
• Sra Helper'S Hands, LLC
• Srubs Uniforms N More
• Hannah Michelle St. Louis, DPT, PT

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Conyers, GA
• Providers in Conyers, GA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2018; 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.