Spencer M. Paterson, M.D.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

033669 Issued in GA

Practice address

195 E Tollison St
Baxley, GA 31513

Phone

(912) 366-6088

Fax

(912) 705-4195

NPI assigned

Oct 29, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lower Oconee Community Hospital Inc

  • Critical Access Hospital
  • Glenwood, GA
  • NPI 1184771586
  NPD
• Jenkins County Hospital LLC

  dba Optim Medical Center - Jenkins

  • Critical Access Hospital
  • Millen, GA
  • NPI 1497064679
  NPD (past)
• Lower Oconee Community Hospital, Inc

  dba Glenwood Family Clinic

  • Rural Health Clinic/Center
  • Glenwood, GA
  • NPI 1043335193
  NPD (past)
• Vidalia Open MRI, LLC

  • Magnetic Resonance Imaging Radiologic Technologist
  • Vidalia, GA
  • NPI 1164599353
  NPD (past)
• Wheeler County Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Glenwood, GA
  • NPI 1588646251
  NPD (past)

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1306025267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "fax_number": "904-450-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 E TOLLISON ST",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "31513",
            "telephone_number": "912-366-6088",
            "fax_number": "912-705-4195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1702-A Meadows Lane",
            "address_purpose": "LOCATION",
            "city": "Vidalia",
            "state": "GA",
            "postal_code": "30474",
            "country_code": "US",
            "telephone_number": "912-537-9421",
            "fax_number": "912-538-0984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATERSON",
        "first_name": "SPENCER",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-29",
        "last_updated": "2023-03-07",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "033669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000540262F",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "033669",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Optim Orthopedics LLC (Optim Orthopedics Baxley)
• Optim Orthopedics, LLC (Optim Orthopedics)
• Optim Orthopedics, LLC (Optim Orthopedics)
• Orthostance Medical LLC
• Molly Elizabeth Paterson, BCBA
• Mika Elani Pearson, LAPC
• Amanda Kay Petty, FNP-BC
• Platinum PT LLC
• Precision Family Healthcare, LLC
• Precision Labs II LLC

• Interventional Pain Medicine Physician in Baxley, GA
• Providers in Baxley, GA by specialty
• Interventional Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.