Interventional Spine and Pain Management, PC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

INTERVENTIONAL SPINE AND PAIN MANAGEMENT, PC

Practice address

5303 Adams St.
Suite C
Covington, GA 30014

Phone

(678) 729-8590

Fax

(678) 729-8595

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Robin J Fowler, M.D.

Title

Medical Director

Phone

(770) 929-9033

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Interventional Spine and Pain Management Center, PC

  • Interventional Pain Medicine Physician
  • Conyers, GA
  • NPI 1023481918

  O20070130000066

  Same enrollment
• Interventional Spine and Pain Management Center, PC

  • Interventional Pain Medicine Physician
  • Decatur, GA
  • NPI 1154780914

  O20070130000066

  Same enrollment
• Interventional Spine and Pain Management Center, PC

  • Interventional Pain Medicine Physician
  • Dawsonville, GA
  • NPI 1265892293

  O20070130000066

  Same enrollment
• The Interventional Spine and Pain Management Center PC

  • Interventional Pain Medicine Physician
  • Atlanta, GA
  • NPI 1326409566

  O20070130000066

  Same enrollment
• The Interventional Spine and Pain Management Center PC

  • Interventional Pain Medicine Physician
  • Cartersville, GA
  • NPI 1376999094

  O20070130000066

  Same enrollment
• The Interventional Spine and Pain Management Center, PC

  • Interventional Pain Medicine Physician
  • Conyers, GA
  • NPI 1518012004

  O20070130000066

  Same enrollment

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Camp Creek LLC

  • Specialist
  • Atlanta, GA
  • NPI 1356685390
  NPPES parent name

Practitioners 2

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

• Shawn Christopher Cable, M.D.

  • Interventional Pain Medicine Physician
  • Atlanta, GA
  • NPI 1558310151
  NPD
• Thien (Steven) D. Quach, MD

  • Pain Medicine (Anesthesiology) Physician
  • Snellville, GA
  • NPI 1184658031
  NPD

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388620800000",
    "number": "1275633372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5303 ADAMS ST.",
            "address_2": "SUITE C",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "30014",
            "telephone_number": "678-729-8590",
            "fax_number": "678-729-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5303 ADAMS ST.",
            "address_2": "SUITE C",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "30014",
            "telephone_number": "678-729-8590",
            "fax_number": "678-729-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL SPINE AND PAIN MANAGEMENT, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2014-01-02",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-929-9033",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Covington, GA
• Providers in Covington, GA by specialty
• Anesthesiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.