Athens Spine Wellness Center LLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

152 Issued in GA

Legal business name

ATHENS SPINE WELLNESS CENTER LLC

Practice address

830 King Ave
Athens, GA 30606-2889

Phone

(706) 425-2400

Fax

(706) 425-2410

NPI assigned

Nov 6, 2013

Organization subpart

Yes

Parent organization

ATHENS SPINE CENTER PCAs reported in NPPES

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

Authorized official

Name

William Megdal, M.D.

Title

President

Phone

(706) 425-2400

Specialties & licenses 1

Addresses

Other identifiers 3

Part of

Athens Spine Center PC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Athens Spine Center PC

  • Pain Medicine Physician
  • Athens, GA
  • NPI 1053488189
  NPPES parent name

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383696000000",
    "number": "1306275748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 KING AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062889",
            "telephone_number": "706-425-2400",
            "fax_number": "706-425-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 KING AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062889",
            "telephone_number": "706-425-2400",
            "fax_number": "706-425-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENS SPINE WELLNESS CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATHENS SPINE CENTER PC",
        "enumeration_date": "2013-11-06",
        "last_updated": "2013-11-06",
        "status": "A",
        "authorized_official_last_name": "MEGDAL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-425-2400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "GA",
            "license": "152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "537122616A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373133496A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000275646B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Athens Sleep and Wellness Center
• Athens Spinal Rehabilitation Center
• Athens Spine & Neurological Surgery
• Athens Spine Center PC
• Athens Spine Procedural Center LLC
• Athens Strength and Physical Therapy, LLC
• Athens Surgery Center LLC
• Athens Surgical Group PC
• Athens Therapy Co-Op
• Athens Thoracic & Vascular Surgery, PC

• Pain Medicine Physician in Athens, GA
• Providers in Athens, GA by specialty
• Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; 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.