Active NPI
M & M Interventional Spine
- Interventional Pain Medicine Physician
- Jasper, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Pain Medicine Physician
- License
- 058527
- Legal business name
- M & M INTERVENTIONAL SPINE
- Practice address
- 91 Sammy McGhee Blvd Ste 101
Jasper, GA 30143-7704 - Phone
- (706) 253-3367
- Fax
- (706) 253-3361
- NPI assigned
- Mar 8, 2011
- Last updated
- Mar 8, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sallu Jabati
- Title
- Medical Director
- Phone
- (678) 559-4526
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | |||
| Interventional Pain Medicine Physician | 208VP0014X | 058527 | GA | Primary |
Addresses
Primary practice location
91 Sammy McGhee Blvd Ste 101
Jasper, GA 30143-7704
Mailing address
91 Sammy McGhee Blvd Ste 101
Jasper, GA 30143-7704
Phone (706) 253-3367
National Provider Directory
National Provider DirectoryLocations
91 Sammy McGhee Blvd
Ste 101
Jasper, GA 30143
Phone (706) 253-3341
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Internal Medicine Physician
- Chandler, AZ
- NPI 1235104431
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299542400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1299542400000",
"number": "1205134673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 SAMMY MCGHEE BLVD STE 101",
"city": "JASPER",
"state": "GA",
"postal_code": "301437704",
"telephone_number": "706-253-3367",
"fax_number": "706-253-3361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91 SAMMY MCGHEE BLVD STE 101",
"city": "JASPER",
"state": "GA",
"postal_code": "301437704",
"telephone_number": "706-253-3367",
"fax_number": "706-253-3361"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "M & M INTERVENTIONAL SPINE",
"organizational_subpart": "NO",
"enumeration_date": "2011-03-08",
"last_updated": "2011-03-08",
"status": "A",
"authorized_official_last_name": "JABATI",
"authorized_official_first_name": "SALLU",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "678-559-4526"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208VP0014X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "GA",
"license": "058527",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jasper, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.