Aviator Pain & Spine, LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

AVIATOR PAIN & SPINE, LLC

Practice address

304 Insperon Dr
Grovetown, GA 30813-0605

Phone

(214) 717-0806

NPI assigned

Oct 25, 2023

Last updated

Mar 6, 2024By 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

Hari Prabhakar, MDNPI 1669887311

Title

Cmo

Phone

(706) 222-4559

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CBHCDD

Practitioners 1

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.

• Hari Prabhakar, MD

  • Interventional Pain Medicine Physician
  • Grovetown, GA
  • NPI 1669887311
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1306618160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13748 CINNABAR PL",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 INSPERON DR",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308130605",
            "telephone_number": "214-717-0806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVIATOR PAIN & SPINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-25",
        "last_updated": "2024-03-06",
        "certification_date": "2024-02-14",
        "status": "A",
        "authorized_official_last_name": "PRABHAKAR",
        "authorized_official_first_name": "HARI",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "706-222-4559",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Arely Avila
• Judieth Evonne Baker-Brown, M.D.
• Villa Baker
• Lesley Barnes
• Barneys Pharmacy Grovetown LLC (Barneys Pharmacy)

• Pain Medicine (Anesthesiology) Physician in Grovetown, GA
• Providers in Grovetown, GA by specialty
• Pain Medicine (Anesthesiology) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.