Organization Active NPI

North Georgia Pain Clinic

  • Pain Medicine Physician
  • Canton, GA
National Provider Identifier
1326137100
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
NORTH GEORGIA PAIN CLINIC
Practice address
1320 Oakside Dr
Suite 203
Canton, GA 30114-2475
Phone
(770) 479-2322
Fax
(770) 720-7695
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Authorized official

Name
Denise H Straus
Title
Practice Administrator
Phone
(770) 479-2322

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

1320 Oakside Dr
Suite 203
Canton, GA 30114-2475

Mailing address

1320 Oakside Dr
Suite 203
Canton, GA 30114-2475
Phone (770) 479-2322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050629000760 GA Part B Supplier - Clinic/Group Practice 7719923861 Receives reassigned benefits from 4 practitioners
Practice locations: Lagrange, GA; Atlanta, GA; Canton, GA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2038397North Georgia Pain Clinic1320 Oakside Drive, Suite 203, Canton, GA 30114AccreditationAug 27, 2027

National Provider Directory

National Provider Directory

Locations

285 Boulevard NE
Ste 600
Atlanta, GA 30312

1320 Oakside Dr
Ste 203
Canton, GA 30114
Phone (770) 479-2322

1320 Oakside Dr
Canton, GA 30114

17 Bowen Ct
Cartersville, GA 30120
Phone (706) 295-0070

304 W Main St
Cumming, GA 30040

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1168

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658793600000",
    "number": "1326137100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 OAKSIDE DR",
            "address_2": "SUITE 203",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142475",
            "telephone_number": "770-479-2322",
            "fax_number": "770-720-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 OAKSIDE DR",
            "address_2": "SUITE 203",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142475",
            "telephone_number": "770-479-2322",
            "fax_number": "770-720-7695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH GEORGIA PAIN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A",
        "authorized_official_last_name": "STRAUS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "770-479-2322"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.