Southeast Regional Pain Ctr PC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

027027 Issued in GA

Legal business name

SOUTHEAST REGIONAL PAIN CTR PC

Practice address

5669 Whitesville Road
Columbus, GA 31904

Phone

(706) 571-7246

Fax

(706) 571-8820

NPI assigned

Aug 29, 2006

Last updated

Feb 14, 2017By 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

Dr. Kenneth Barngrover, DONPI 1588787162

Title

President

Phone

(706) 571-7246

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.60964
• FHIR API: https://fhir4.healow.com/fhir/r4/BAFHDD

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.

• Kenneth Barngrover, D O

  • Interventional Pain Medicine Physician
  • Columbus, GA
  • NPI 1588787162
  Medicare reassignment Care Compare group Authorized official
• Jesse Lockhart Jr., PA-C

  • Physician Assistant
  • Columbus, GA
  • NPI 1316121106
  Medicare reassignment Care Compare group
• Peggy Holder, NP

  • Nurse Practitioner
  • Columbus, GA
  • NPI 1578748216
  NPD (past)
• Rajan Gupta, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Cherry Hill, NJ
  • NPI 1114997962
  NPD (past)
• Stacey English White, CRNP

  • Nurse Practitioner
  • Greenville, AL
  • NPI 1649530932
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1194833970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7757",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319087757",
            "telephone_number": "706-571-7246",
            "fax_number": "706-563-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5669 WHITESVILLE ROAD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31904",
            "telephone_number": "706-571-7246",
            "fax_number": "706-571-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST REGIONAL PAIN CTR PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "BARNGROVER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-571-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "027027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raquelle R Southard, SLP
• Southeast Brain & Spine Surgery, P.C.
• Southeast Brain and Spine PC
• Southeast Lung & Critical Care Specialists, PC (Southeast Lung Associates)
• Southeast Lung & Critical Care Specialists, PC (Southeast Lung Associates)
• Southeastern Anesthesia Group LLC
• Southeastern Cardiology Associates PC
• Southeastern Dental Center-Columbus LLC
• Southeastern Endoscopy Center LLC
• Southeastern Gastroenterology Associates, PC

• Interventional Pain Medicine Physician in Columbus, GA
• Providers in Columbus, 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 Feb 14, 2017; 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.