Georgia Interventional Pain Associates, LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

GEORGIA INTERVENTIONAL PAIN ASSOCIATES, LLC

Practice address

1157 Forsyth St Ste 200
Macon, GA 31201-7454

Phone

(478) 476-1968

NPI assigned

Mar 31, 2023

Organization subpart

No

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

Authorized official

Name

Dr. William Benjamin Smisson, MDNPI 1992138366

Title

Physician

Phone

(478) 476-1968

Specialties & licenses 1

Addresses

Other names 1

• GA Interventional Pain Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 3

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

• William Benjamin Smisson, MD

  • Interventional Pain Medicine Physician
  • Macon, GA
  • NPI 1992138366

  GA

  Medicare reassignment Authorized official
• Margaret C. Boltja, M.D.

  • Interventional Pain Medicine Physician
  • Macon, GA
  • NPI 1184671133

  GA

  Medicare reassignment NPD
• Joshua Shane Young, N.P.

  • Family Nurse Practitioner
  • Macon, GA
  • NPI 1295086999
  NPD

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1245935261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 FORSYTH ST STE 200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017454",
            "telephone_number": "478-467-1968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 FORSYTH ST STE 200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017454",
            "telephone_number": "478-476-1968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA INTERVENTIONAL PAIN ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-31",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "SMISSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "478-476-1968",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GA Interventional Pain",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Macon, GA
• Pain Medicine (Anesthesiology) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.