NPIMap

Organization Active NPI

Minimally Invasive Neurospine and Pain Institute, PC

Doing business as AllSpine Surgery center

  • Ambulatory Surgical Clinic/Center
  • Riverdale, GA
National Provider Identifier
1255607628
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE, PC
Doing business as
AllSpine Surgery center
Practice address
33 Upper Riverdale Rd SW
#25
Riverdale, GA 30274-2626
Phone
(770) 997-0600
Fax
(770) 991-5576
NPI assigned
Mar 29, 2012
Last updated
Mar 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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

Authorized official

Name
Shahram Rezaiamiri, MDNPI 1225217920
Title
Physician
Phone
(770) 997-0600

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X GA Primary

Addresses

Primary practice location

33 Upper Riverdale Rd SW
#25
Riverdale, GA 30274-2626

Mailing address

900 Eagles Landing Pkwy
Stockbridge, GA 30281-7343
Phone (770) 997-0600

Other names 1

  • AllSpine Surgery center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1332979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332979200000",
    "number": "1255607628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817343",
            "telephone_number": "770-997-0600",
            "fax_number": "770-991-5576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 UPPER RIVERDALE RD SW",
            "address_2": "#25",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742626",
            "telephone_number": "770-997-0600",
            "fax_number": "770-991-5576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-29",
        "last_updated": "2012-03-29",
        "status": "A",
        "authorized_official_last_name": "REZAIAMIRI",
        "authorized_official_first_name": "SHAHRAM",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "770-997-0600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AllSpine Surgery center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverdale, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; 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.