NPIMap

Organization Active NPI

Peachtree Spine & Pain Physicians, Inc

Doing business as Peachtree Spine Physicians, Inc

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Hapeville, GA
National Provider Identifier
1336458355
Registry record updated Nov 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
046109 Issued in GA
Legal business name
PEACHTREE SPINE & PAIN PHYSICIANS, INC
Doing business as
Peachtree Spine Physicians, Inc
Practice address
771 Virginia Ave
Hapeville, GA 30354-1911
Phone
(404) 843-3323
Fax
(404) 574-5944
NPI assigned
Sep 27, 2010
Last updated
Nov 11, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
PEACHTREE SPINE & PAIN PHYSICIANS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 11, 2010

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

Authorized official

Name
Dr. Jeffrey S Grossman, MDNPI 1104823145
Title
President
Phone
(404) 843-3323

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X 046109 GA Primary

Addresses

Primary practice location

771 Virginia Ave
Hapeville, GA 30354-1911

Mailing address

5555 Peachtree Dunwoody Rd NE
Ste 201
Atlanta, GA 30342-1703
Phone (404) 843-3332

Other names 1

  • Peachtree Spine Physicians, Inc Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Peachtree Spine and Pai6 organizations share this tax ID, including this one
Part of
Peachtree Spine and Pai

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

771 Virginia Ave
Hapeville, GA 30354

Practitioners & affiliated clinicians

Practitioners 11

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": "1285545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289433600000",
    "number": "1336458355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD NE",
            "address_2": "STE 201",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421703",
            "telephone_number": "404-843-3332",
            "fax_number": "404-574-5944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 VIRGINIA AVE",
            "city": "HAPEVILLE",
            "state": "GA",
            "postal_code": "303541911",
            "telephone_number": "404-843-3323",
            "fax_number": "404-574-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE SPINE & PAIN PHYSICIANS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEACHTREE SPINE & PAIN PHYSICIANS, INC",
        "enumeration_date": "2010-09-27",
        "last_updated": "2010-11-11",
        "status": "A",
        "authorized_official_last_name": "GROSSMAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-843-3323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "GA",
            "license": "046109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peachtree Spine Physicians, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hapeville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; 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.