Palmetto Pain Management of Ga, LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

71017 Issued in GA

Legal business name

PALMETTO PAIN MANAGEMENT OF GA, LLC

Practice address

5745 Clarion St
Cumming, GA 30040-0305

Phone

(803) 779-3263

Fax

(803) 779-3207

NPI assigned

May 13, 2015

Organization subpart

Yes

Parent organization

PALMETTO PAIN MANAGEMENT, LLCAs reported in NPPES

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

Authorized official

Name

Jennifer Hodge

Title

Practice Administrator

Phone

(803) 779-3263

Specialties & licenses 1

Addresses

Part of

Palmetto Pain Management LLC

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17099/brand/4/csg/1/fhir/r4

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

{
    "created_epoch": "1431475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1336527191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 BERNARDIN AVE",
            "address_2": "SUITE 240",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042039",
            "telephone_number": "803-779-3263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5745 CLARION ST",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300400305",
            "telephone_number": "803-779-3263",
            "fax_number": "803-779-3207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO PAIN MANAGEMENT OF GA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALMETTO PAIN MANAGEMENT, LLC",
        "enumeration_date": "2015-05-13",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "HODGE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "803-779-3263"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "GA",
            "license": "71017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Padmavathi V. Pagadala, M.D.
• Joseph Chunmin Pak
• Julie Elaine Palkowitsh, FNP
• Pallipain LLC
• Michael D Palmer, D.D.S.
• Rujuta Palsule, DDS
• Isabella Maria Palumbo, PH.D.
• Lauren Palumbo
• Jessica Pamperin, MS, CCC-SLP
• Meghan Shelton Panagopoulos, OTR/L

• Pain Medicine (Anesthesiology) Physician in Cumming, GA
• Providers in Cumming, 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 May 13, 2015; 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.