Georgia Interventional Pain - T, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

GEORGIA INTERVENTIONAL PAIN - T, LLC

Practice address

2565 Thompson Bridge Rd Ste 102
Gainesville, GA 30501-1723

Phone

(770) 962-3642

NPI assigned

Feb 28, 2025

Last updated

Apr 15, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amit S Patel, MD

Title

Ceo

Phone

(770) 962-3642

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295532968. Details of each certification follow.

• CCN 11C0001599 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 11C0001599

Legal name

GEORGIA INTERVENTIONAL PAIN- T, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Mar 31, 2026

Last certification

Mar 13, 2026

Ownership / control type

Proprietary

Facility address

2565 Thompson Bridge Rd, Ste 102
Gainesville, GA 30501

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1740700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744675200000",
    "number": "1295532968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 PHILIP BLVD STE 140",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468768",
            "telephone_number": "770-962-3642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 THOMPSON BRIDGE RD STE 102",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305011723",
            "telephone_number": "770-962-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA INTERVENTIONAL PAIN - T, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-28",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "AMIT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-962-3642",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Georgia Dept of Human Resouces Field Fiscal Services - Region II
• Georgia Developmental Center
• Georgia Elite Ambulance Service Inc. (Elite Ambulance Service)
• Georgia Emergency Department Services, P.C.
• Georgia Heart Institute LLC
• Georgia Ketamine Renew
• Georgia Medport LLC
• Georgia Mountain Commmunity Services
• Georgia Mountain Community Partners (Avita Community Partners)
• Georgia Mountain Community Services (Avita Community Partners)

• Ambulatory Surgical Clinic/Center in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.