NPIMap

Organization Active NPI

Pain Care LLC

  • Anesthesiology Physician
  • Stockbridge, GA
National Provider Identifier
1265607626
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
GA028685 Issued in GA
Legal business name
PAIN CARE LLC
Practice address
1365 Rock Quarry Rd
Ste 202
Stockbridge, GA 30281
Phone
(770) 771-6580
Fax
(770) 771-6589
NPI assigned
Apr 28, 2008
Last updated
Dec 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Authorized official

Name
Vincent Galan, MDNPI 1831180983
Title
President
Phone
(770) 435-2713

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X GA028685 GA Primary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X GA028685 GA

Addresses

Primary practice location

1365 Rock Quarry Rd
Ste 202
Stockbridge, GA 30281

Mailing address

1365 Rock Quarry Rd
Ste 202
Stockbridge, GA 30281
Phone (770) 771-6580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090218000234 GA Part B Supplier - Clinic/Group Practice 0244395689 Receives reassigned benefits from 12 practitioners
Practice locations: Johns Creek, GA; Stockbridge, GA; Newnan, GA; Lawrenceville, GA; Griffin, GA; Fayetteville, GA
O20131217001576 GA DME Supplier - Physician - Interventional Pain Management 0244395689 Practice locations: Stockbridge, GA

National Provider Directory

National Provider Directory

Member organizations 5

Organizations listed as members of this organization in the National Provider Directory.

Locations

3790 Pleasant Hill Rd
Ste 120
Duluth, GA 30096
Phone (404) 458-9956

1267 Highway 54 W
Ste 5300
Fayetteville, GA 30214
Phone (770) 461-4824

600 Lanier Ave W
Ste 204
Fayetteville, GA 30214

610 S 8th St
Ste G
Griffin, GA 30224
Phone (678) 358-8841

619 S 8th St
Ste 300
Griffin, GA 30224

6300 Hospital Pkwy
#265
Johns Creek, GA 30097

6300 Hospital Pkwy
Ste 265
Johns Creek, GA 30097

105 Corporate Plaza Dr
#A
Lagrange, GA 30241
Phone (678) 800-0099

67 Old Jackson Rd
McDonough, GA 30252

1605 Highway 34 E
Ste B
Newnan, GA 30265

2401 Newnan Crossing Blvd E
Ste 120
Newnan, GA 30265

6525 Professional Pl
Riverdale, GA 30274
Phone (770) 233-3444

1365 Rock Quarry Rd
Ste 202
Stockbridge, GA 30281
Phone (770) 960-2701

Practitioners & affiliated clinicians

Practitioners 12

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": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293494400000",
    "number": "1265607626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 ROCK QUARRY RD",
            "address_2": "STE 202",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "770-771-6580",
            "fax_number": "770-771-6589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 ROCK QUARRY RD",
            "address_2": "STE 202",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "770-771-6580",
            "fax_number": "770-771-6589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2010-12-28",
        "status": "A",
        "authorized_official_last_name": "GALAN",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-435-2713",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "GA028685",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "GA",
            "license": "GA028685",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; 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.